I am standing with a group of seven nervous strangers in the drawing room of the pretty Georgian manor house where the evangelist Methodist cleric John Wesley used to preach.
These days however, this 70-acre estate on the edge of Bath is home to a new evangelism, one that promises to transform health and lives – which is why we’re all here.
Combe Grove is a health centre specialising in transforming poor metabolic health (the umbrella term used to describe poor health caused by such conditions as high blood pressure, high blood sugar levels, high cholesterol and a large waist) which significantly increases your chance of developing heart disease, type 2 diabetes, dementia and having a stroke.
They won’t, however, be offering us medication to get our health back on track.
Instead, the approach used here is part of a wider movement that focuses on a lifestyle approach to tackling chronic health problems.
Sue Ryan decided to attend the retreat at Combe Grove because after a routine blood test and with no warning symptoms, she was diagnosed with type 2 diabetes, which increases the risk of stroke
Based on solid science, this kind of approach is being backed by some of the leading health experts in the country.
In December 2023, for example, Lord Nigel Crisp, former chief executive of the NHS, was among those who launched a campaign under the banner of the Beyond Pills All Party Parliamentary Group, to reduce the number of antidepressants prescribed – which they say work only for most severely depressed patients and bring side-effects – with a focus on non-drug treatments.
This is because research now shows that the lifestyle approach can be surprisingly beneficial. Last year, for example, researchers at Vrije University in the Netherlands found that regular, 45-minute group running sessions were as effective as the antidepressant escitalopram at reducing symptoms of depression.
The focus at Combe Grove is on restoring metabolic health by, for example, following time-restricted eating (where you eat only within certain hours of the day), consuming sufficient protein and vegetables, avoiding processed food, exercising daily, developing good sleeping habits and learning stress management techniques.
Numerous studies show these techniques can not only help you lose weight but can lead to an improvement in overall health and increased mental alertness.
Simply cutting back on carbohydrates can reduce blood pressure, HbA1C (average blood sugar levels) and improve cholesterol levels, according to results at one GP practice reported the BMJ last year.
Dr Campbell Murdoch, an NHS GP who specialises in metabolic health and who helped devise the programme at Combe Grove, says it can be improved, ‘sometimes very swiftly and sometimes radically’.
He uses a car as a metaphor: fix the body’s engine and the majority of illnesses will sort themselves out. An old banger becomes a reliable saloon.
Dr Campbell cites the example of a 54-year-old patient who came to see him with acid reflux, high blood pressure, pre-diabetes, depression, irritable bowel syndrome and back pain – and who was being medicated for each of these problems.
He persuaded his patient to follow a metabolic health regimen and all those symptoms disappeared within six months – he no longer needed medication.
My fellow retreaters have come here as they are feeling sluggish, overweight and stressed: the initial tests we’re given reveal that some are pre-diabetic.
I decided to try this programme because five months earlier, after a routine blood test and with no warning symptoms, I was diagnosed with type 2 diabetes – and I know diabetes increases the risk of stroke.
This concerns me greatly as two years before, out of the blue, I had a stroke.
Combe Grove is a health centre specialising in transforming poor metabolic health (the umbrella term used to describe poor health caused by such conditions as high blood pressure, high blood sugar levels, high cholesterol and a large waist)
Before then I exercised daily, my blood pressure had always been relatively low, I drank very little and did not smoke.
In fact my health had been so good I did not even know the name of the GP I’m registered with.
When I had the stroke the doctors told me there was a clot blocking 70 per cent of the artery to my brain.
At the time, Covid dictated that I say goodbye to my family at A&E and there was a chance it would be for the last time.
I was lucky. I lost movement on my left side but, with daily physiotherapy, quickly regained it and in time made a full physical recovery.
The only difference to my life now is that I take a blood pressure and a blood-thinning pill every day – but most of all I know not to take my health for granted.
Which is what brings me to Combe Grove.
Although many people lose significant amounts of weight by the end of a retreat, the aim here is to set you on a new path for life that you can continue at home (they also support you for 48 weeks after leaving with regular contact and tests).
Day one starts with tests measuring key markers for metabolic health – including muscle mass, blood sugar levels, blood pressure and the ratio of triglycerides (bad fats) to HDL cholesterol (the beneficial type).
Before we arrived, we were sent fingerprick blood tests to measure our HbA1c level – a measure of your blood ‘sugariness’, it reflects your average blood glucose levels over the previous three months.
The threshold for diabetes is 48mmol/mol; for pre-diabetes it’s 42-48.
Mine, though much reduced in the previous three months thanks to me following a low-carb diet, is still 43. I want it to be below 39.
They also measure our height/waist ratio: your waist should be less than half our height. So if you are 6ft (72in) tall, your waist should be no more than 36in. A ratio of over 0.5 suggests there is too much fat around your middle.
Blood pressure should be 120/60 – mine is 155/83 at that moment, but I know that it is higher whenever it is first taken. Even so, I need to reduce it.
Next, I step onto the Accuniq machine which measures body composition and calculates visceral fat – a type that wraps around the abdominal organs and produces inflammatory compounds. The reading should be nine or below, although ten is acceptable.
Mine is 11, making me viscerally obese and raising my risk for heart disease, diabetes, Alzheimer’s and stroke.
For the fats ratio – which shows the density of the fats in the blood – the lower the better.
Mine is a satisfactory 0.8 – you want it to be under 0.9, so this is OK.
And so the programme begins: mornings are devoted to classes on the five ‘roots’ of good metabolic health; nutrition, movement, sleep, environment and mindset (which covers everything from meditation to positive thinking).
We eat twice a day: brunch at 10.45am and supper at 5.45pm, in line with the policy of time-restricted eating (TRE), which underlies the programme.
We are told that leaving a long interval between eating gives the body a break from digestion, allowing it to perform other important functions including ‘spring cleaning’ and encouraging it to burn fat, reducing inflammation.
A raft of studies support TRE, including one in the journal Cell Metabolism in 2018 which showed it makes your cells more responsive to insulin (good, because it mops up that harmful sugar from the blood) and lowered blood pressure and oxidative stress (that leads to cell damage) in men with prediabetes.
We were allowed no processed food and had to have protein with every meal. Meal plates should contain 25 per cent protein, 60 per cent non-starchy vegetables and 15 per cent starchy foods with healthy fats.
We’re told to reduce our intake of starchy carbs and foods with added sugars.
Healthy fats such as olive oil and nuts are encouraged – as is lots of water.
There are exercise classes, swimming and yoga. We are taught the importance of a daily routines of 20 squats and 20 wall presses to build muscle. If that’s too easy, add weights.
We also walk for at least 30 minutes a day (the monitor clamped to my arm shows my blood sugar levels drop significantly on a walk).
Other advice includes moving for ten minutes after meals to aid digestion, taking magnesium supplements and turning off screens for an hour before bedtime to aid sleep.
Although some of the mindset sessions felt a little less science-based – with phrases such as ‘gratitude is verbal sunshine’, Dr Murdoch assures me ‘everything here is evidence-based and needs to be true to testable science’.
The afternoons are free for treatments – reflexology, acupuncture, physiotherapy, osteopathy and massage.
Yes, it’s hardly arduous – and nor is it cheap. It cost me around £1,800 for the week (I had an introductory early bird offer) and currently prices range between £2,400 and £2,900.
But for me, it has been worth it.
At the end of the week I have lost over half a stone, my energy is restored, and I am full of resolve to stick to a better lifestyle.
Nor do I find it hard to broadly follow these principles once I’m home. If we’re going out to supper, for instance, I simply eat my first meal later in the day.
Six weeks later I return to Combe Grove for more tests – and it’s good news.
I have lost 3.5cm off my waist, bringing the height to waist ratio down to 0.54.
My HbA1c is a glorious 37 – well below the pre-diabetes threshold. My blood pressure is down to 130/60.
My visceral fat levels are reduced to ten, so I am no longer classed as viscerally fat. The fats ratio is 0.38 – even better than before.
There are other changes too: my shoes feel slightly big and my rings are looser on my fingers, indicating less inflammation.
Old clothes fit once again, and I buy some size-10 jeans.
Perhaps most noticeable of all is a lifting of my mood. I have more energy, the afternoon ‘slump’ has gone.
Able to contemplate doing things I thought my stroke had put behind me forever, I book a trip to India.
I then hit a blip over a long summer holiday when my eating habits relaxed – and my HbA1c goes back up to 41. But at least my visceral fat levels and weight remain the same.
Dr Murdoch reassures me that progress ‘is not always in straight line’ and I manage to get back to better habits.
A year after my diabetes diagnosis and six months after going to Combe Grove, I have a review at my GP’s surgery. Blood tests show I am no longer diabetic and reveal improvements to my liver and kidney function.
And when I return to Combe Grove a couple of months later for a three-night ‘returners’ retreat’, there’s more good news.
My overall fat mass has decreased and my muscle has increased. The fats ratio is now standing at a wonderful 0.25. My visceral fat level remains at ten.
My metabolic age is now a year younger than my actual age and my blood sugar level at 41 is just hovering around the normal and pre-diabetic level.
For now, Combe Grove benefits people like me who can afford a ‘holiday’ with huge health benefits – but bursaries are planned for GPs to refer patients who cannot afford it, so they can come to the retreats.
In my case the results will hopefully prevent me from troubling the NHS much in the future – and the added bonus doing this without having to be put on any diabetes medication.
