Nhs Back Door Low Carb?

[Mbaker]

Yesterday I did a "Type 2 - Patient Conference" course (which replaced the Xpert course in the North East Essex area). There were 21 participants and 4 "Experts" covering, general diabetes, diet, psychology and carbs. We were split across 3 tables with the Experts rotating. There were the usual messages about Type 2 being progressive (this word was used several times offering no hope which was disappointing). Some of the good things were explaining insulin resistance, the role of the pancreas, insulin, the liver, kidneys and HbA1c. Complications were also detailed.

The Big Surprises
In the carbs section they had a carb pile and non - carb, we had to say which foods went on which - many were surprised. There was no slight of hand regarding pasta, potatoes, rice and similar. There was some good advice not to double up on carbs e.g. potatoes and lasagne, and reducing the portion size of spaghetti Bolognese. They had one card which was low carb, omlette with salad, which they said could be replaced with vegetables. The Expert presenting this section said carbs are meals should be between 30 and 50 grams across 3 meals. I asked what if you are eating twice a day, the response was 2 x 30, I pushed and said wasn't this low carb, she replied this was enough.

In the general diabetes section the Expert stated 30 to 60 grams per meal across 3 meals.

I make this an "official" minimum of 90 grams of carbs which is low carb territory. Note that I did not include high fat. Saturated fat was metaphorically executed as the devil incarnate, with just olive oil alongside vegetable oils being promoted. The Experts also said that the Eatwell Guide is getting revisited.

Has anyone else experienced this change of position or is this just a local Essex thing.

 

[Jenny15]

Yesterday I did a "Type 2 - Patient Conference" course (which replaced the Xpert course in the North East Essex area). There were 21 participants and 4 "Experts" covering, general diabetes, diet, psychology and carbs. We were split across 3 tables with the Experts rotating. There were the usual messages about Type 2 being progressive (this word was used several times offering no hope which was disappointing). Some of the good things were explaining insulin resistance, the role of the pancreas, insulin, the liver, kidneys and HbA1c. Complications were also detailed.

The Big Surprises
In the carbs section they had a carb pile and non - carb, we had to say which foods went on which - many were surprised. There was no slight of hand regarding pasta, potatoes, rice and similar. There was some good advice not to double up on carbs e.g. potatoes and lasagne, and reducing the portion size of spaghetti Bolognese. They had one card which was low carb, omlette with salad, which they said could be replaced with vegetables. The Expert presenting this section said carbs are meals should be between 30 and 50 grams across 3 meals. I asked what if you are eating twice a day, the response was 2 x 30, I pushed and said wasn't this low carb, she replied this was enough.

In the general diabetes section the Expert stated 30 to 60 grams per meal across 3 meals.

I make this an "official" minimum of 90 grams of carbs which is low carb territory. Note that I did not include high fat. Saturated fat was metaphorically executed as the devil incarnate, with just olive oil alongside vegetable oils being promoted. The Experts also said that the Eatwell Guide is getting revisited.

Has anyone else experienced this change of position or is this just a local Essex thing.

NZ doctors and nurses tend to have this revised view of carbs, in my experience. Because I've lived in different towns around the country since diagnosis 9 years ago I've seen several HCPs and they all have this low carb-friendly view. There will be some stick in the mud traditionalists here but I think they are in the minority. NZ culture values early adopters in most areas of life. Number 8 fencing wire and all that.

 

[Guzzler]

I guess there will be some kick back from tbe 'Cholesterol Clubbers'. It ain't going to be easy.

 

[Mbaker]

I guess there will be some kick back from tbe 'Cholesterol Clubbers'. It ain't going to be easy.

I make you right, the food adverts on TV are still pushing fat free. But the foundations are looking shaky for the status quo as the course was technically all over the place. None of the educators would commit to the level of calories and man or woman should now have as the guidelines are about to change soon apparently, and when the "carb" choice lady did her part, she could have come from the pro LCHF / Keto army. I know when the States have their dietary assessment in 2020 low carb is one of the agenda items.
It is getting harder for the powers that be but there have been some major concessions, such as "Cholesterol is not a nutrient of concern for overconsumption" since 2015 in the States https://health.gov/dietaryguidelines/2015-scientific-report/06-chapter-1/d1-2.asp.

 

[Guzzler]

I make you right, the food adverts on TV are still pushing fat free. But the foundations are looking shaky for the status quo as the course was technically all over the place. None of the educators would commit to the level of calories and man or woman should now have as the guidelines are about to change soon apparently, and when the "carb" choice lady did her part, she could have come from the pro LCHF / Keto army. I know when the States have their dietary assessment in 2020 low carb is one of the agenda items.
It is getting harder for the powers that be but there have been some major concessions, such as "Cholesterol is not a nutrient of concern for overconsumption" since 2015 in the States https://health.gov/dietaryguidelines/2015-scientific-report/06-chapter-1/d1-2.asp.

I was seeing it a little more simply. Possible scenario = DN says lower your carbs increase healthy fats . GP says lower your fats or go on statins. Patient result? Confusion.

 

[Mbaker]

I was seeing it a little more simply. Possible scenario = DN says lower your carbs increase healthy fats . GP says lower your fats or go on statins. Patient result? Confusion.

Not to dissimilar, after yesterday, if I was a newbie I would not know what to eat, as with one hand they said eat carbs etc and the next they had them in the spiking your glucose pile. The fat side of the course was clear as to the message and protein was not mentioned as much.

 

[malcs90]

NZ doctors and nurses tend to have this revised view of carbs, in my experience. Because I've lived in different towns around the country since diagnosis 9 years ago I've seen several HCPs and they all have this low carb-friendly view. There will be some stick in the mud traditionalists here but I think they are in the minority. NZ culture values early adopters in most areas of life. Number 8 fencing wire and all that.

My diabetes nurse put me on high fat low carb diet which my go also endorses. Since Feb lost 1 1/3 stone and doc pleased with last blood test which showed great improvement.

 

[Bluetit1802]

"Cholesterol is not a nutrient of concern for overconsumption"

I was at the surgery this morning waiting to have my review bloods taken. There is a TV screen in there with looped videos. The one I saw today almost made me fall off my seat. An NHS dietician explaining the difference between dietary cholesterol in foods (offal/prawns/eggs) and body cholesterol. She said what has been said many times on this forum - our livers make our cholesterol according to what is needed. Dietary cholesterol has almost no effect on body cholesterol. That is the first time I have heard that from the NHS. Too many people arrive on this forum afraid to eat eggs. However, she did demonise saturated fats, as usual.

 

[lucylocket61]

Hurrah!!

(waves pompoms and falls off soapbox)

 

[Mr_Pot]

I was at the surgery this morning waiting to have my review bloods taken. There is a TV screen in there with looped videos. The one I saw today almost made me fall off my seat. An NHS dietician explaining the difference between dietary cholesterol in foods (offal/prawns/eggs) and body cholesterol. She said what has been said many times on this forum - our livers make our cholesterol according to what is needed. Dietary cholesterol has almost no effect on body cholesterol. That is the first time I have heard that from the NHS. Too many people arrive on this forum afraid to eat eggs. However, she did demonise saturated fats, as usual.

This was in 2012 so only 6 years to filter through!
https://www.ncbi.nlm.nih.gov/pubmed/22037012

 

[ickihun]

I was at the surgery this morning waiting to have my review bloods taken. There is a TV screen in there with looped videos. The one I saw today almost made me fall off my seat. An NHS dietician explaining the difference between dietary cholesterol in foods (offal/prawns/eggs) and body cholesterol. She said what has been said many times on this forum - our livers make our cholesterol according to what is needed. Dietary cholesterol has almost no effect on body cholesterol. That is the first time I have heard that from the NHS. Too many people arrive on this forum afraid to eat eggs. However, she did demonise saturated fats, as usual.

The thyroid affects cholesterol too. We don't know why yet but underactive thyroid sufferers normally don't have high cholesterol.