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LOW CARB DIET - A NEWBIES GUIDE

Discussion in 'Low-carb Diet Forum' started by fergus, Mar 30, 2009.

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  1. fergus

    fergus Type 1 · Well-Known Member

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    Diabetes.co.uk has no agenda to promote any particular dietary approach towards controlling diabetes. However, many members have found a low carbohydrate diet to be uniquely beneficial. As newbies often have many questions about low carb diets and since they are rarely discussed by health professionals, this thread will attempt to answer some of those most commonly asked.

    Why low carb?

    The chief symptom of diabetes is an elevated blood glucose level. While some medications can help to reduce blood glucose, a reduction of foods in the diet which significantly raise levels in the first place can itself be sufficient to normalise them. Medications can therefore often be reduced (in consultation with healthcare professionals) and in some cases (type 2 diabetics only) eliminated altogether.

    Which foods are restricted?

    Lowering the intake of obvious sugars is clearly beneficial in controlling blood glucose. However, starchy carbohydrates such as bread, pasta, rice and potatoes and foods containing processed flours are also metabolised by the body to produce large amounts of glucose. As they contain very few micronutrients (vitamins and minerals) low carb diets often reduce or eliminate only these foods.

    Which foods are included?

    A low carb diet is not necessarily low in all carbohydrate foods, simply those which disrupt blood glucose and insulin levels. Many contain large quantities of vegetables, with the exception of some starchy root vegetables. Typically, they also include nuts and some fruits. Generally, they include the healthy natural and unprocessed foods similar to those eaten in populations where diabetes and heart disease are rarely found. In this category comes meat, fish, eggs and dairy foods including butter and cream. Vegetarian protein sources such as tofu, quorn and TVP can also be included .
    The impact of particular foods on blood glucose can vary greatly between individuals and testing after meals is recommended to figure out which foods to safely include in your diet.
    In broad terms, carbohydrates have a large impact on blood glucose levels, protein much less, and fats have little if any effect.

    How low is low?

    An effective low carb diet is one which maintains, most of the time, a healthy blood glucose level. The amount of carbs it contains will vary between individuals. The consensus on the forum is that the following applies:

    Low carb (ketogenic) 0-50g carbohydrate per day
    Typical low carb 50-90g
    Liberal low carb 90-130g
    Moderate carbs 130-170g
    High carb 170g plus a day


    What is a healthy blood glucose level?

    A healthy non-diabetic will typically have a blood glucose level within a tightly controlled range, usually below 5mmol/l for the majority of the time. This equates to a glycated haemoglobin (HbA1c) of below 5%. The current health service ‘target’ HbA1c of 7% is roughly equivalent to an average blood glucose approximately 50% higher than that of a non-diabetic.

    What about cholesterol?

    Diabetics are right to be fearful of the risks of heart disease, since rates are many times higher than those of non-diabetics.
    Since around 80% of the cholesterol in the body is actually manufactured by the liver and the cells, relatively little comes directly from the diet. Total cholesterol is however now widely recognised as a very poor indicator of heart disease risk.
    Far more meaningful are the individual components of total cholesterol, known as high density lipoprotein (HDL) and triglycerides. Trig. / HDL ratio is perhaps the single most significant measure of heart disease risk.
    The lower the triglycerides and the higher the HDL, the better.
    Insulin and glucose combine to raise triglycerides and lower HDL, which is why a low fat, high carbohydrate diet may actually increase heart disease risk. It’s commonly reported that those on low carb diets have lower cholesterol levels and certainly much improved trig. / HDL ratios.

    What about weight loss?

    Insulin is often referred to by biochemists as the fat building hormone. In fact, the body cannot make body fat without insulin. It is very unusual to find an overweight individual who doesn’t also have elevated insulin levels. Type 2 diabetics, at diagnosis, will often be overproducing insulin.
    Insulin also inhibits the body’s use of stored fat as a source of fuel. Lowering insulin levels is extremely important, perhaps essential, for weight loss to succeed. This is one reason why low carb diets are particularly successful in weight loss since the fewer the carbs, the less insulin is required. Some may also find that they consume fewer calories without feeling hungry because their fat metabolism begins to work properly once more, allowing the body access to energy reserves in fat stores which were previously inaccessible.

    Ketosis / Ketoacidosis

    Diabetics, and even some health professionals, often confuse two quite distinct metabolic processes - ketosis and ketoacidosis. Ketosis is a perfectly natural and healthy state during which the body uses stored or dietary fat for fuel. In order to enter this state, carbohydrate intake needs to fall below a certain level. Ideally, a healthy metabolism should regularly use ketosis, while fasting overnight for example, to fuel the body's processes and utilise stored fat reserves. Most of the body's organs, the heart for example, in fact run very efficiently on ketones.
    Ketoacidosis is quite different and is typically the result of a chronic lack of insulin, not a lack of carbohydrate. With insufficient insulin, the body attempts to fuel itself by breaking down fat and protein stores in an uncontrolled way, a process which results in the blood becoming dangerously acidic. In short, ketosis usually occurs when blood sugars are at the lower end of the normal range, and ketoacidosis occurs when blood sugars are dangerously elevated. Ketosis is a result of low carbohydrate intake, ketoacidosis is a result of inaquate insulin levels.

    What about physical energy?

    Strictly speaking, we burn neither glucose nor fat for physical energy. Energy within our cells actually comes from a molecule called adenosine triphosphate, or ATP. When its molecular bonds are broken, energy is released in the mitochondria, the power plants of our cells. A glucose molecule will generate 36 ATP molecules. A 6 carbon fatty acid molecule will generate 48 ATP molecules. Therefore, when insulin levels are low and the body can access fatty acids as a fuel source, physical energy levels can actually increase on a low carb diet.
    Anecdotally, many on low carb diets often report feeling considerably more energetic, without the peaks and troughs of energy which appear to come with a diet high in carbohydrates.

    Is it suitable for type 1 diabetics?

    The benefits of reduced insulin levels also apply to type 1’s. Insulin has a measureable impact on blood vessels by narrowing them, with increased cardiovascular risks. Smaller doses can also make blood glucose fluctuations far more predictable, resulting in fewer highs and lows. It is not true to say that type 1’s need carbohydrates to feed their insulin. They may simply need less insulin.

    Why doesn’t the NHS recommend low-carb diets?

    Great question. Largely because it was once thought that dietary fat caused heart disease and dietary protein caused kidney damage, so without carbs there’d be nothing left to eat. Subsequent research has revealed that neither of these hypotheses was correct and that the finger of suspicion ought to be pointed at glucose, but changes to established mindsets are very slow to happen.

    Isn’t low carb just another diet fad?

    Since the emergence of the human species in the Rift Valley around 3-4 million years ago, we have been meat eaters. Fruit and vegetables were a rare treat during their short growing seasons. We only began cultivating crops during the agricultural revolution 10,000 years ago. Refined sugars and starches became our staples around 200 years ago.
    In the context of our evolutionary history, perhaps it’s the ‘healthy balanced diet’ which is the real diet fad?
     
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  2. sugarless sue

    sugarless sue · Master

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    Comments on Low carb diet - a newbies guide

    Gold star Fergus.This will be a sticky in Low carb forum.

    Note, the original thread is here.

    viewtopic.php?f=18&t=7215&start=0
     
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  3. cugila

    cugila · Master

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    Fergus.
    Fantastic. Clear and concise - just the way it should be. Platinum Award.

    Ken.
     
  4. celtictemple

    celtictemple Type 2 · Member

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    Thanks for this great precis of low carb diet. I have been on it now for 1 week ( 50-100g daily) and have lost 6lbs already bringing me from obese to overweight BMI and my BS levels are now averageing just over 5.0 per day which is fantastic. My fasting BS level this morning was 4.9 which has never been seen before-usually 7s and 8s. I just hope I have the will power to keep to it and not break it. I assume it is still OK to have the odd lapse when visiting friends and relatives or go out for the odd meal as long asone doesn't overindulge the carbs?
     
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  5. whatashock

    whatashock · Well-Known Member

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    Thank you. that does help.

    I have posted elsewhere, and am still a little confused. I was diagnosed last monday, and cannot get to see the dietician for another 2 months (although it seems they may not give me the best advice anyway)

    I have purchased the collins gem carb counter.

    My question is -

    I am just under 16st (was 17 1/2) 35 year old.

    If I decide to count to 100g Carb, does this mena that I can eat 'processed sandwiches/salads' upto that amount in a day.

    What is a good carb level for me?

    the reason I ask is that my lifestlye keeps me on the road, and I need to find the best way to eat. My levels today are 10.4 but I do have a cold, and only been on Metformin for a week (yesterday was about 9.4)

    I am lucky that I can claim lunch on expences, and have looked at vitrually EVERY salad that M&S do, and I can get a carb value on a nice salad of about 12-15g.

    What is an 'OK' sugar content in a salad like this. I suppose this is the most confusing thing as the collins book does not show sugar it just shows carbs.

    Looking forward to some good advice.
     
  6. Dennis

    Dennis Type 2 · Well-Known Member

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    Hi whatashock,

    Simple answer is yes - but sandwiches aren't the only foods that contain carbs! You really need to look at how much carb you eat during the day and try to even it out. No good overloading your system with 100g carbs for breakfast, which your body's insulin production just wouldn't be able to cope with, then having no more for the rest of the day. Also you may find that you are better able to process carbs at different times of the day. Many people find their metabolism is quite sluggish first thing in the morning so they need a low carb breakfast, but they can deal with higher amounts of carb later in the day.

    That's impossible for any of us to tell you. It all depends on how much insulin you produce, how much insulin resistance you have, how much glucose your liver produces, how much exercise you have, etc. All you can do is experiment with different amounts of carbs and different food types to see what level gives you good blood sugar control. 100g is probably not a bad starting point, then you can reduce or increase the carbs depending on results.

    Any infection or virus will raise your blood sugar while your body concentrates its resources on fighting it.

    That is a very reasonable amount of carbs. If you were to spread 100g through the day as 30g for breakfast, 30g for lunch and 40g for evening meal, then you can see that 12-15g is quite low, so you could perhaps have a piece of fruit (say an apple or pear) with it. The sugar content is simplt the amount of carbs that will convert to blood sugar immediately. The rest converts more slowly. So for example a foof that has 15g carbs, of which 5g sugar, means that the 5g goes straight into your blood and will raise your blood sugar within a few minutes. The remaining 10g will convert to sugar over a longer period, anything from 15 mins to an hour or more.

    Hope that helps.
     
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  7. Trinkwasser

    Trinkwasser · Well-Known Member

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    Outstanding breakdown!

    Anyone who wants more detail should check out most any of the blogs listed here

    http://weightoftheevidence.wordpress.com/

    as you can see there are a mass of people including not a few doctors "on side"
     
  8. GothRosie

    GothRosie · Member

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    In other words then:

    Low carb or ketogenic 0-50g diet is a communist diet (those carbs are the curse of the working classes)
    Therefore a typical low carb diet is a socialist diet
    The Liberal low carb diet can stay as it is
    Moderate carbs is a Tory diet - why change things that have worked for the last 100 years or so
    And the High carb diet is a fascist diet - after all if you can't survive on 170g+ carbs/day then what use are you to society?

    R.
     
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  9. jumbleannie

    jumbleannie · Active Member

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    Thank you for a simple,(like me), explanation. The how many carbs = a low carb diet has been puzzling me for a while, as has the carb/sugar thing. I do like it when people talk in a simple way that you don't need a degree in science to understand :)
     
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  10. eunice

    eunice · Newbie

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    evening all low carbers
    since starting this change to my eating habits i have lost half a stone(first time in years!!!!) and my doctor was very impressed. He had wanted to up my metformin to 4 a day but would like to take my bloods again in july to see how things are going and i can stay on 3 a day. I am so glad i found you . Thank you thank you thank you . I have also stopped my statins and feel so much like my old self.I was expecting to get a frown from my doc but he was very understanding and said that they do not suit all patients and will also watch my cholesterol.I am trying to pass on the low carb message . once again bless you all and thanks
     
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  11. Trinkwasser

    Trinkwasser · Well-Known Member

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  12. samcogle

    samcogle · Well-Known Member

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    Hi, excellent results and well done. I do have the odd lapse as I am sure others do. If I go out for a meal etc I try to stick to the low carb options but if I fancy a treat once in a blue moon I go for it. Have to admit I do then suffer for it and get a sort of hang-over feeling the next day but sometimes just to feel normal, it's worth it :D
     
  13. Trinkwasser

    Trinkwasser · Well-Known Member

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    Long term, reducing your insulin resistance may help. My carb limit at breakfast hasn't changed much but my lunchtime carbs can be increased around 50% and I can get away with about double what I used to be limited to in the evening. Not that I like to do this often.

    Other tricks that *may* help you to put away more carbs on an occasional basis: try a tiny snack of something high carb about half an hour before eating. This will induce a mini-spike but switch your pancreas on in time for the main meal. Also I find a brisk walk round the village immediately after eating, while my pancreas is still at maximum output, can produce a major BG drop. Doesn't work for everyone but such tricks are worth testing to see if they work for you.
     
  14. foxyroxy9393

    foxyroxy9393 · Newbie

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    I was considering whether or not to start a low carb diet. I am 16 and have had diabetes for almost 7 years and never had a hba1c lower than 10 (i think). so i have decided to turn my life around, doing as much as i can to keep healthy especially with my exams in a week. But, i am also vegetarian and has type 1, and even though the previous posts answer most of my questions, was just wondering how much carbohydrate is advisable to eat per day, if i wanted to lose some weight and still have the benefits of having better control? and if i didnt eat carbohydrate at a meal, would i still need insulin?

    thanks

    roxanne <3
     
  15. timo2

    timo2 · Well-Known Member

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    Hi Roxanne,

    Take a look at this link from dsolve.com for some low-carb vegetarian ideas.
    :arrow: How To: Follow a Lower Carb Vegan Diet

    You'll still need insulin to cover any protein in a meal, but a significantly smaller dose than for
    carbohydrate. The blood sugar rise caused by protein peaks at around 3-4 hours, so slower acting
    bolus insulins like Humulin S and Actrapid tend to be better suited to high-protein/low-carb meals.

    Good luck,
    timo.
     
  16. Lilybean

    Lilybean · Member

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    really very interesting and makes complete sense. i've learned alot and know feel i would be better looking at my diet again to make it more balanced and healthy.

    THANK YOU!
     
  17. Moogie1947

    Moogie1947 Type 2 · Well-Known Member

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    Thank you Fergus for laying out such a goodly amount of detail in easy to follow terms.

    I have been low carbing as a vegetarian for a few month now and it is getting easier, at last.
    To any low carb veggies out there, I got the two low carb Rose Elliott books - there are also others on Amazon.
    I am buying a few low carb items online as they are not available in supermarkets or health food shops locally.

    My main problems have been finding suitable food in the sort of self service cafes that retired people like me frequent with our friends - in UK garden centres and National Trust type places. They all sell sandwiches, cakes and high carb vegggie options like pasta bakes or flans.
    It was hard enough as a vegetarian to find a decent sandwich but now I am reduced to asking for a plate of mixed veg and "no I don't want rice or potatoes thanks".
    Salads rarely appear unless accompanied by prawns or ham.

    Anyone cracked this dilemma?
    Keep up the good work,
    Moogie
     
  18. cugila

    cugila · Master

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    Hi moogie.
    This is a perennial problem. The mainstream places just don't cater for low carb/reduced carb diets. As you say it is all 'stodge'. One solution I have found is to take a packed lunch with all the things you know are good for you.

    Most places will substitute items on the Menu and give increased salads or replace Chips etc with a fresh salad, providing it isn't all pre- prepared. You just need to ask what they can do for you.
    That's my solution.

    Ken.
     
  19. Moogie1947

    Moogie1947 Type 2 · Well-Known Member

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    Hi Ken
    Thanks you for your support. Just sometimes it would be nice to eat out though don't you think. We only go out to a proper restaurant as a family once or twice a year anyway as the veggie options are less appetising than my home cooking in most cases. My next problem will be how to negotiate decent meals for a week in a hotel while I'm at a conference abroad next month. Even breakfast will be a nightmare. I used to love breakfasts with a huge range of breads cheese and fruits so will need to rethink them too.
    Moogie
     
  20. hazelfry3

    hazelfry3 · Newbie

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    hi, I am following the Bernstein low carb diet and have lost weight although did not need to lose much. I weighed 10stone 4 lb but now weigh 9stone 9 lb. Will I stop losing weight when my body feels that it is the right weight for me. I am 5 ft 6in. I am nearly 67 and do not take any meds for my Type 2, although I take, statin, bendroflumithiazide, amlodipine and lisinoprol as I had high blood pressure and cholesterol. My blood pressure is good. and BG readings do not go over 6.5 usually first thing in morning. Mostly in 5 range. Sorry to go on just wanted to know about the weight query.
     
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