ZOE is the latest nutrition technology sweeping the nation. My question is: Is ZOE more helpful than it is harmful?
What is ZOE?
Zoe markets themselves as the “World’s most advanced nutrition tech, on your arm”. Aimed at non-diabetics, ZOE uses a Continuous Glucose Monitor (CGM), like a Freestyle Libre, to track how your body and blood sugar responds to food, exercise, stress and sleep, with the aim of improving overall health.
Zoe claims to improve nutrition and help individuals manage their health. They do this in several steps. Firstly, they ask you to do a test kit, which involves a gut health test (sending a sample of faeces to a lab for analysis), a blood fat test (sending a blood sample to a lab for analysis) and finally a blood sugar sensor, where you wear a continuous glucose monitor to get real-time insights into your blood sugar levels. The second step involves getting your test results, using the ZOE tools and gaining access to the ZOE nutritionists.
What is a CGM and how is it usually used?
The step in this process that I am most concerned about is the involvement of Continuous Glucose Monitors in the ZOE process. Continuous glucose monitors (CGMs) are used in the monitoring and self-management of diabetes, and there are many different types of CGMs. I myself use a type of CGM named Dexcom, and have used a few different types of CGM during my time living with Type 1 Diabetes. Having a CGM allows me to better understand and control my blood sugar levels, alarming me if my blood sugar levels are going low or high and making my day-to-day life a bit easier. The reason I need this is because the cells in my pancreas responsible for producing insulin no longer work, meaning I will need to replace the insulin my body no longer makes for the rest of my life. Having a CGM makes the incredibly difficult balancing act of replicating a body’s natural process slightly easier.
On the flip side of that, having a CGM can be incredibly overwhelming. With the Dexcom CGM that I am on, I get a blood glucose reading sent to both my insulin pump and phone every 5 minutes and whilst extremely helpful, it can often be information overload. There are so many factors that affect blood glucose apart from just food, such as physical activity, hormones, and weather, and getting your blood sugar perfect 24/7 is an impossible task. When you receive your blood sugar in a graph format, displaying every single mistake you’ve made in the day, it can be demoralising. You strive for a completely flat line in the graph, even though that is an unrealistic goal, and it can become obsessive.
My Concerns about ZOE
It sometimes can be hard to remember that even non-diabetics don’t have a flat line in their blood sugar levels. If someone ate food, for example, there would be a natural (small) spike in blood sugar after food, which the body would automatically correct for. My fear about the use of the ZOE CGMs on non-diabetic individuals is that firstly they overly focus on the completely natural spikes in their blood sugar. The factors that affect blood sugar in non-diabetics have already been evidenced, and so if individuals are aware of these factors, there is no need to wear an expensive health monitor that would only cause unnecessary anxiety. Additionally, Dr Shivani Misra, a diabetes consultant at Imperial College London, said: “By overly focusing on one aspect of your metabolism, i.e. glucose, an individual might be neglecting all of the over aspects of their metabolism and health”. Can using ZOE lead to other problems with your health, rather than fixing problems?
Can ZOE lead to disordered eating?
My main concern about ZOE is that having the CGM may increase the monitoring of food, eating and weight, much as it does for an individual with Type 1 Diabetes, leading to an increased prevalence of disordered eating in the wider population: “diabetes may increase risk for an eating disorder by increasing attention and monitoring of food, eating, and weight. This preoccupation can become a bit of an obsession—particularly if people think they have to be perfect in their diabetes management.” Having access to the data that ZOE provides could mean individuals get obsessed with the spikes in their blood sugar, leading to maladaptive methods of controlling said spikes in blood sugar levels, which in turn can lead to wider issues.
ZOE still in trial phase
Finally, I am concerned that many people are accessing ZOE whilst it is still in its trial phase. The evidence isn’t clear that the process is truly beneficial, and I am concerned that this process could cause a lot of harm to individuals who are truly trying to better themselves. If you are worried about your blood sugar due to family history of diabetes, or you feel you may be having symptoms of diabetes, please seek advice from a qualified medical professional before purchasing and using a potentially unnecessary medical device.
I wanted to write this blog as I am continually getting adverts about ZOE bombarding my social media, with different celebrity endorsements. With the constant diet culture in this world, I am concerned that ZOE would only add to this in a negative way.
Until next time,
Alyssa
Note: I am not a medical professional or expert in this topic, I am an individual living with Type 1 Diabetes.
Here are some further articles that discuss ZOE: