Now the X-PERT advice is low carb, high fat

[tim2000s]

Why can't it just be called a healthy diet?

 

[Deakint]

Dear Low Carbers,
Thank you for your support after the debate at Diabetes UK last March. This made me realise that I had to listen to people with diabetes and it stimulated me to investigate the low carb high fat lifestyle in much more detail.

You have raised some questions and I thought I would take this opportunity to answer them. X-PERT Health is a registered charity with a mission to provide evidence-based information and education so that people with long-term conditions can make informed decisions regarding self-managing their condition.

Regarding the X-PERT diabetes structured education programmes, I undertake literature reviews annually and update the educators manual with the latest evidence base. Educators are required to attend update training every two years. The latest version (12.1) of the Educator's Manual (published Sept 14) acknowledges the latest evidence for a very low carb/high fat lifestyle although it doesn’t prescribe it. Our philosophy is that we provide people with the latest evidence and they decide whether its an approach they wish to try. Equally so, we have never prescribed a high carb diet. It has always been the case that people learn what carbs are and which foods contain them. In week 3, people are then supported in assessing how many carbs they are eating and setting goals to reduce if they wish to reduce blood glucose levels and/or lose weight. Generally we find that most people reduce their carb intake after becoming more carb aware.

Hands up - I am the first to admit that for many years I believed that consuming too much fat (especially saturated fat) was bad for us. This is what we were taught at university. However, in the latter years I have critically analysed the original research for the diet-heart hypothesis and now realise that this is seriously flawed and there isn't actually any evidence that saturated fat causes heart disease. The latest handbook is our attempt to inform the public of this fact. The handbook is a step-by-step guide to following a very low carb diet i.e. less than 50g per day and this will only be a long-term strategy if people embrace fat.

We have just completed a pilot with a GP practice in Herts (80 patients) – 2 x standard X-PERT programmes versus 2 x low carb X-PERT programmes and the University of Herts are analysing the results. We are working in partnership with the university and applying for National Institute of Health Research funding to undertake a feasibility study and clinical trial.

Please do get back to me with any further queries - I appreciate your support and realise that there is still a long way to go!

Best wishes, Trudi

 

[tim2000s]

Thanks for coming on to the forum and clearing that up Trudi. Nice to see the trials taking place and look forward to seeing the results.

 

[dannyw]

Why is it called low carb high fat... Why can't the H be changed to Healthy fat??

The H can be whatever you want it to be. How about Happy fat lol. I think the important thing is the food itself, too many people get hung up on the name.

 

[Pipp]

Dear Low Carbers,
Thank you for your support after the debate at Diabetes UK last March. This made me realise that I had to listen to people with diabetes and it stimulated me to investigate the low carb high fat lifestyle in much more detail.

You have raised some questions and I thought I would take this opportunity to answer them. X-PERT Health is a registered charity with a mission to provide evidence-based information and education so that people with long-term conditions can make informed decisions regarding self-managing their condition.

Regarding the X-PERT diabetes structured education programmes, I undertake literature reviews annually and update the educators manual with the latest evidence base. Educators are required to attend update training every two years. The latest version (12.1) of the Educator's Manual (published Sept 14) acknowledges the latest evidence for a very low carb/high fat lifestyle although it doesn’t prescribe it. Our philosophy is that we provide people with the latest evidence and they decide whether its an approach they wish to try. Equally so, we have never prescribed a high carb diet. It has always been the case that people learn what carbs are and which foods contain them. In week 3, people are then supported in assessing how many carbs they are eating and setting goals to reduce if they wish to reduce blood glucose levels and/or lose weight. Generally we find that most people reduce their carb intake after becoming more carb aware.

Hands up - I am the first to admit that for many years I believed that consuming too much fat (especially saturated fat) was bad for us. This is what we were taught at university. However, in the latter years I have critically analysed the original research for the diet-heart hypothesis and now realise that this is seriously flawed and there isn't actually any evidence that saturated fat causes heart disease. The latest handbook is our attempt to inform the public of this fact. The handbook is a step-by-step guide to following a very low carb diet i.e. less than 50g per day and this will only be a long-term strategy if people embrace fat.

We have just completed a pilot with a GP practice in Herts (80 patients) – 2 x standard X-PERT programmes versus 2 x low carb X-PERT programmes and the University of Herts are analysing the results. We are working in partnership with the university and applying for National Institute of Health Research funding to undertake a feasibility study and clinical trial.

Please do get back to me with any further queries - I appreciate your support and realise that there is still a long way to go!

Best wishes, Trudi

Thank you.
My concern is for the people who have been on previous courses recommending low fat and high carbs. How will new information be communicated to them?

 

[Bluetit1802]

Thanks Trudi for your explanation. I hope your post stops the "going round in circles" arguments on the thread.

 

[Paul59]

True.. I may just do that.

 

[Paul59]

Why is it called low carb high fat... Why can't the H be changed to Healthy fat??

totally agree High Fat is misleading to newbies.

 

[Deakint]

Hi Pipp - we advise NHS organisations that they invite people to attend an annual update but unfortunately we have no power to enforce this.

 

[Andy12345]

Thankyou Trudi

 

[zand]

Yes thanks for making the time and effort to post here Trudi.

 

[Deakint]

I love the fact that you post your weight / HbA1c results - true evidence

 

[Bluetit1802]

I love the fact that you post your weight / HbA1c results - true evidence

Many of us do this in our signatures. Perhaps you can collate some of this evidence!

 

[Totto]

Hi Trudi, I think you are brave even with all the scientific evidence behind you to follow science and what us patients say. Almost the whole world has been taught to fear fat so there is an enormous amount of re-educating people on fat to be done. Good luck with it!

 

[Deakint]

You know - I think it would be an excellent idea to collect all the self-reported evidence and then attempt to publish it in one of the diabetes journals to raise awareness amongst healthcare professionals. The reason why I say "attempt" is because there may be publication bias but it is definitely worth a try. I would be happy to collate all the results and write up if you wanted me to.

 

[zand]

That sounds like a brilliant idea!

 

[Andy12345]

Terrific

 

[Andy12345]

You're more than welcome to use mine.

Her name is Trudi, not
removed unnecessary remark Anna29

 

[Deakint]

OK - anybody who wants to be involved. if you want to email me at [email protected] by 16th February with the following information:
1. Date started on low carb diet
2. Grams of carbs per typical day
3. HbA1c levels with dates
4. Weight levels with dates
5. Any other clinical indicators especially triglycerides, HDL, LDL, blood pressure, eGFR, GGT (liver function test), waist size, CRP (level of inflammation) with dates
6. Any other benefits e.g. increased energy levels, reduced hypoglycaemia, better sleep, reduced hunger etc.
7. Any negatives?
8. Any other comments

I will then draft a paper and circulate to you for approval all before submission. I think Primary Care Diabetes would be a good journal. Also what about the Diabetes UK Balance magazine??

 

[Deakint]

OK - anybody who wants to be involved. if you want to email me at [email protected] by 16th February with the following information:
1. Date started on low carb diet
2. Grams of carbs per typical day
3. HbA1c levels with dates
4. Weight levels with dates
5. Any other clinical indicators especially triglycerides, HDL, LDL, blood pressure, eGFR, GGT (liver function test), waist size, CRP (level of inflammation) with dates
6. Any other benefits e.g. increased energy levels, reduced hypoglycaemia, better sleep, reduced hunger etc.
7. Any negatives?
8. Any other comments

I will then draft a paper and circulate to you for approval all before submission. I think Primary Care Diabetes would be a good journal. Also what about the Diabetes UK Balance magazine??

p.s. 9. Diabetes medication at the start and medication now!