Marian Devereaux is 51 and lives in Cork. Now her family's grown up she should be enjoying her grandchildren and living life to the full, but coeliac disease is making her feel old and miserable. If she doesn't sort out her lifestyle now she's not only potentially wrecking the quality of her life but also reducing how long she could live.
Marian works 3 days a week in a busy call centre, she finds her condition makes it difficult to get through the day as she is often bloated and exhausted.
Dr Hamilton is to send Marian for a complete medical to discover if her untreated coeliac disease is already having an impact on her body.
Almost one percent of the Irish population suffer from coeliac disease. Symptoms include fatigue, diarrhoea, muscle spasms and skin problems. Although it's not life threatening if it's not treated it can increase the risk of osteoporosis.
Marian has only recently been diagnosed with coeliac disease and has spent her whole life eating foods that make her ill. Avoiding gluten would result in a complete remission of the disease, and Dr Mark is convinced if she started being more careful with her diet she would transform her life.
Marian is going to undergo a complete health screening, Marian's heart and blood pressure are monitored during exercise to check if there are any signs of heart disease. Heart problems have a strong genetic link and both Marian's parents died of heart disease - her father at the young age of 55.
But Marian ran when she was younger and despite feeling constantly tired has tried to keep up some level of activity. She has also been a non-smoker for five years so Dr Mark hopes that the heart test doesn't pick anything up. The results show that although she could be fitter her heart is healthy.
The capacity of her lungs is then tested and her height and weight are measured to calculate her body mass index. Her result - a BMI of 29 - means that she is overweight.
Next Marian's cholesterol is measured - her heart may be healthy now but if her cholesterol is raised then there may be an increased risk of heart disease and stroke in the next 20 years.
Marian's blood was sent to the lab for various tests. Dr Mark wanted to find out if anything apart from untreated coeliac disease was causing Marian's fatigue. He also wanted to check if her love of sugary snacks was already causing diabetes.
The doctor at the clinic explained the serious health risks Marian could face if she didn't stick to a gluten free diet. For instance, osteoporosis could be a problem in the future. She also explained that osteoporosis is not just a danger for people suffering from coeliac disease. In particular it can affect women who are post-menopausal. A third of all women over 50 will be affected by osteoporosis and a quarter of women will suffer a fracture due to the disease by the age of 60.
Although Marian was healthy and her blood results had shown no abnormalities the health screening had highlighted some issues that Dr Mark needed to address - she wasn't unwell at the moment but if she didn't change her lifestyle she could be in a few years.
At 5 Marian's cholesterol levels are good but she needs to ditch the snacks and increase her activity if she wants to keep them that way.
At 11kg over her ideal weight Marian's Body Mass Index is 29 - she should be aiming to be 25 or less.
Marian's high salt intake means her blood pressure was slightly elevated - she needs to reduce this to help avoid stroke and heart disease.
Marian was feeling old and tired but Dr Mark was convinced that if she tackled her diet and upped her activity then in just 8 weeks she would be a different person.
Dr Mark is convinced that in just 8 weeks he can help Marian transform the way she feels and improve her life expectancy. His plan is to get her to follow a well-balanced low-fat gluten free diet. He also wants her to minimise the risk of osteoporosis by increasing her calcium intake to 3 portions a day. He also wants her to increase her exercise to at least 3 sessions a week and encourage fun activities to improve her wellbeing.
Before tackling her diet Dr Mark decides to start with the fun activities. For years Marian has wanted to try ballroom dancing. In the Dr's 8-week plan you don't wait to try new things, you just do it!
Dr Mark wants dancing to become one of Marian's 3 sessions of exercise a week. Not only will it improve her life expectancy but it will also create endorphins that will make her feel better and increase her energy.
After the success of the dancing it was time to tackle Marian's diet. Marian needs to deal with her coeliac disease once and for all and Ann-Marie Brennan, a dietician with specialist knowledge of the condition, was the woman to help.
Fruit and vegetables are naturally gluten free and Ann-Marie's advised her to aim for at least 5 portions a day. Most meat and fish will also be fine.
Ireland has one of the highest prevalence's of coeliac disease in the world and for its many sufferers shopping can be a nightmare. Even if there's no mention of gluten in a list of ingredients that's no guarantee the product is gluten free. From now on Marian will need to refer to a book issued by the Coeliac Society which lists products it is safe for her to eat. Shopping had just got a lot more complicated!
Once Marian startled to tackle her diet there was no stopping her. With dancing giving her only an hours' exercise a week she's decided to do two sessions of circuit training. Not only was Marian improving her fitness she was also beginning to change her state of mind.
Research into how mood effects life expectancy is in its infancy but it has been found that someone's personality type can affect how healthy they are. A good laugh improves circulation and lowers your blood pressure. Laughter also helps to boost the body's immune system, by increasing production of the killer cells and proteins in the blood that help destroy tumours and viruses. A small child laughs about 300 times a day, the average adult only manages 17 times.
By week 7 Marian's beginning to become acclimatised to her new lifestyle. The feeling of exhaustion that used to dog her afternoons at work are at last beginning to disappear.
8 weeks ago Marian was reducing her life expectancy and was feeling tired and rundown. A medical found she was unfit and overweight and her diet contained too much salt and sugar. She was also not eating enough calcium to potentially protect her bones from osteoporosis.
But Marian has turned her life around and today she finds out whether the new diet and activity plan has improved her health and life expectancy.
Weight 64kg - previously 68kg
BMI 27 - previously 29
13 to 17 years potentially added onto her life expectancy - if she continues her new lifestyle. And it's not just the quantity of years, the quality of those years is equally, if not more, important.