Diet browsing

[Andy12345]

i agree tottaly my doctor and dn are both nice people but completely insane (imho) they havent got a clue! in fact my dn said to me at my last visit "why are you here? you know more than me" for the blood tests was my reply, i s aw a different doctor last time as mine wasnt there, she was the single most horrible person i ever came across, she was like an indian jones nazi, i had just had blood tests that where amazing she didnt once ask me how id done it, all she said was your cholesterol was a little high we ill increase your statins, when they had just gone down by 4 points since last visit and i hadnt even been taking them, i actually asked her if she was joking, on dx my doctor said to me "your a ticking bomb and within 5 years of major organ failure, dont eat sugar, bye" i cant even remember all the bad experiences ive had, the list is long, i am completely disillusioned by the whole industry, if i had not found this site and all the good folks advice, i just dont know where i would be now, if not in the ground

 

[Thommothebear]

I'd be interested to see what diet advice others received in truth.

Myself, usual healthy diet, the eat well plate, that we all appear to love to demonise.

.

In my case It was the standard NICE approved balanced diet sheet that I was given, preprinted and with proportions similar to the eatwell plate. Entreaties to avoid saturated fats, and increase the amount of starchy carbs. When I did my Xpert course earleir this year the same advice was given initially, but to be entirely fair they said that was just the current official line and that other diets including low carb will work better for some people.

Another good thing is that my blood pressure which was getting quite high late last year at 160/90 in a 24 hour monitoring test, is now down to 130/65, whether that is due to the dietary change or the increased exercise I've been getting since june this year I dont know.

 

[lizzief]

So, yes, it was the correct advise at the time, and if you take the effort to work it out, a portion controlled, "healthy" diet of about 2000 calories, with 1/3 made up of fairly low GI foods is 700 calories, or 175 g of carbs.
But then, it's not even that, as a lot of the carbs they suggest are fibre, so I don't see the demons force feeding sugar into us here.
..

It may have been correct for you but that doesn't make it correct for everyone. My diet before diagnosis was very different from yours - I'd been on the Slimming World plan for years. Nothing fried, tiny amounts of low-fat cheese and fat-free yoghurt, unlimited lean meat or fish and as much veg and complex carbs as I wanted, apart from the fact that bread was limited to a couple of slices of wholemeal at most. No white bread or rice, no mashed spuds. I cut out all sugar apart from the stuff the 'healthy eating' industry crams into it's fake foods. The diet sheet my doctor gave me and the advice on the training session were the same as the SW guidelines. I was encouraged to eat 'masses' of fruit as snacks. I didn't have anything like 2000 calories a day pre-diagnosis, nor 175g of carb.

Whether we take our carbs as potato or pure sugar by the spoonful, it still ends up as glucose so your comment about being force-fed sugar is irrelevant, although if we're told by our doctors to eat piles of carbs of ANY Kind, we may as well be force-fed sugar. the GI Index makes very little difference to my body's reaction - high GI send the level up high and fast but it comes down fairly quickly, lower GI send it up to a lower spike level and over a longer timescale but take much longer to return to normal.

My gripe with the NHS is that they give the same advice to everyone without having any idea about their previous lifestyle and diet - it's one size fits all and just get on with letting them prescribe ever-increasing medication. My GP is happy with patients who routinely have a pre-breakfast BG of anything under 9. It also seems that as a body they have no idea that Type1 and Type2 are different. My brother is type1 and adjusts his insulin according to his carb intake and BG level. I can't do that so have to adjust my food intake according to my BG level.

The correct way to advise Type2s should be to issue them with meters and tell them that the NHS diet sheet is a rough guide only and a starting point for them to use as a basis for their self-management.

 

[douglas99]

Hi douglas99.
'the eat well plate that we all appear to love to demonise', as you call it, includes 'PLENTY of potatoes, bread, rice, pasta and other starchy foods '.

On another thread today you advised a poster to 'Avoid classic bad foods first. ... potatoes, white rice, white pasta, white bread, anything like that.
Personally, I avoid all root veg, most rice apart from a bit of basmati occasionally, all pasta, as I test myself and know they spike me'.

So you clearly believe that the eat well plate is wrong. WHY do you find it so distressing to say this, or to suggest that the NHS is giving bad advice?

Because everything is relative.
Selective quoting of their advice is not a brilliant strategy, particularly as I have given you a breakdown that gives you the real figure carbs that is recommended.
As you have also quoted me, nhs advice is to avoid food I listed. They advise avoiding white rice, pasta, bread. as to potatoes, maybe I shouldn't have put them on, nhs suggest baked are ok, some of us are ok with them, I know I'm not.

I did state what I do personally, I probably should have put them there..
But why do you believe that the nhs should be advising others to switch to my personal preferences in the initial stage?
As I said, I have tuned my diet for me personally over a couple of years. It suits me, not someone else.

 

[douglas99]

It may have been correct for you but that doesn't make it correct for everyone. My diet before diagnosis was very different from yours - I'd been on the Slimming World plan for years. Nothing fried, tiny amounts of low-fat cheese and fat-free yoghurt, unlimited lean meat or fish and as much veg and complex carbs as I wanted, apart from the fact that bread was limited to a couple of slices of wholemeal at most. No white bread or rice, no mashed spuds. I cut out all sugar apart from the stuff the 'healthy eating' industry crams into it's fake foods. The diet sheet my doctor gave me and the advice on the training session were the same as the SW guidelines. I was encouraged to eat 'masses' of fruit as snacks. I didn't have anything like 2000 calories a day pre-diagnosis, nor 175g of carb.

Whether we take our carbs as potato or pure sugar by the spoonful, it still ends up as glucose so your comment about being force-fed sugar is irrelevant, although if we're told by our doctors to eat piles of carbs of ANY Kind, we may as well be force-fed sugar. the GI Index makes very little difference to my body's reaction - high GI send the level up high and fast but it comes down fairly quickly, lower GI send it up to a lower spike level and over a longer timescale but take much longer to return to normal.

My gripe with the NHS is that they give the same advice to everyone without having any idea about their previous lifestyle and diet - it's one size fits all and just get on with letting them prescribe ever-increasing medication. My GP is happy with patients who routinely have a pre-breakfast BG of anything under 9. It also seems that as a body they have no idea that Type1 and Type2 are different. My brother is type1 and adjusts his insulin according to his carb intake and BG level. I can't do that so have to adjust my food intake according to my BG level.

The correct way to advise Type2s should be to issue them with meters and tell them that the NHS diet sheet is a rough guide only and a starting point for them to use as a basis for their self-management.

"The correct way to advise Type2s should be to issue them with meters and tell them that the NHS diet sheet is a rough guide only and a starting point for them to use as a basis for their self-management"

I agree entirely.
It's a starting point.

 

[equipoise]

I think you have done more than 'tune' your diet -- you avoid starchy carbs and the NHS positively urges their consumption. The way that you have 'tuned' your diet matches what many other diabetics have found to be a necessary way of changing the NHS recommendations. You are in good company. Why not join us in suggesting that the NHS advice can be positively harmful to the newly-diagnosed who are not equipped with testing strips and do not for a moment think that they can question or adapt what the NHS recommends?
I'm not attacking you -- quite the opposite. I'm also not attacking the NHS -- I have actually had pretty good support. It's because I believe in the NHS that I think it is so wrong that in this instance they are providing bad advice. Surely we should be trying to help them change it?

 

[AnnieC]

Surely it's our prerogative to post as we see fit!
Personally I've had two bad experiences with my GPs concerning diabetic care, which has damaged my faith in them! No doubt there are many decent teams out there, but conversely there are bad ones too. You are a prolific poster, have picked a lot of brains and received very helpful, insightful information. Sorry, but I don't understand why you are now being critical of those who feel they have little support or a poor rapport with their HCT and choose to voice it here.

No I am not being critical of people who feel their HCT have failed them in some way and if you read my post again you will see that I did say that I am sure some have had a bad experience with theirs All I said was some people on this forum have said that HCT teams in general are not good with diabetes as they give the wrong advice about diet when I am sure some people have a really good HCT who support them well and isn't that what we all need
Can someone tell me just what the bad advice is that the NHS give to diabetics

 

[Thommothebear]

The correct way to advise Type2s should be to issue them with meters and tell them that the NHS diet sheet is a rough guide only and a starting point for them to use as a basis for their self-management.

Hallelueya to that, with the proviso that they should be trained on how to read and interpret the results, something that the Xpert course and presenters put great emphasis on.

 

[douglas99]

I think you have done more than 'tune' your diet -- you avoid starchy carbs and the NHS positively urges their consumption. The way that you have 'tuned' your diet matches what many other diabetics have found to be a necessary way of changing the NHS recommendations. You are in good company. Why not join us in suggesting that the NHS advice can be positively harmful to the newly-diagnosed who are not equipped with testing strips and do not for a moment think that they can question or adapt what the NHS recommends?
I'm not attacking you -- quite the opposite. I'm also not attacking the NHS -- I have actually had pretty good support. It's because I believe in the NHS that I think it is so wrong that in this instance they are providing bad advice. Surely we should be trying to help them change it?

Because, dare I say it, I doubt we're in the majority of diabetics.
When I was diagnosed, I needed advice on what to eat then, and I needed a change I could manage.
The nhs diet was a lot better than my old one.

As to being diagnosed?

It's a complete lifestyle change.
Or it isn't.
Or somewhere in between.
Depends entirely on the patient.

So, what's the most sensible option.
Choose a simplistic diet most people can manage, and will show rewards for the majority of patients?

Or choose an extreme diet, that the majority won't maintain, and to be honest, the majority won't understand.

Overall it's good advice for most people, they can follow it, it's normally better than their previous diet.

 

[lizzief]

Can someone tell me just what the bad advice is that the NHS give to diabetics

To condense my previous posts into one sentence, the advice I got was 'Don't test, leave that to us, follow this high-carb diet and if things don't seem any better in 6 months we'll increase your medication'. No mention that the diet may need tweaking (at the very least!). actively discouraged from self-testing and encouraging a culture of sit back and let the tablets do all the work.

 

[badcat]

The most recent comment by my diabetes consultant who was initially v sceptical of Low Carb diet as she equated it with Atkins and had concerns re the amount of protein (made on the basis of the improvements seen in my bloodwork), was " low carb is the way to go, if you can stick to it, but unfortunately most of my patients cant / wont make the type of changes needed"

 

[douglas99]

To condense my previous posts into one sentence, the advice I got was 'Don't test, leave that to us, follow this high-carb diet and if things don't seem any better in 6 months we'll increase your medication'. No mention that the diet may need tweaking (at the very least!). actively discouraged from self-testing and encouraging a culture of sit back and let the tablets do all the work.

Whereas I got a meter, not on prescription at that time, just a spare that they had, no mention of a high carb diet, just the healthy 175g of carbs they seem to give most people, and a suggestion to lose weight. Regular reviews, referrals, support, specialists and bloods whenever I wanted.

 

[AnnieC]

To condense my previous posts into one sentence, the advice I got was 'Don't test, leave that to us, follow this high-carb diet and if things don't seem any better in 6 months we'll increase your medication'. No mention that the diet may need tweaking (at the very least!). actively discouraged from self-testing and encouraging a culture of sit back and let the tablets do all the work.

No thats not what my DN told me to do

I think you have done more than 'tune' your diet -- you avoid starchy carbs and the NHS positively urges their consumption. The way that you have 'tuned' your diet matches what many other diabetics have found to be a necessary way of changing the NHS recommendations. You are in good company. Why not join us in suggesting that the NHS advice can be positively harmful to the newly-diagnosed who are not equipped with testing strips and do not for a moment think that they can question or adapt what the NHS recommends?
I'm not attacking you -- quite the opposite. I'm also not attacking the NHS -- I have actually had pretty good support. It's because I believe in the NHS that I think it is so wrong that in this instance they are providing bad advice. Surely we should be trying to help them change it?

So is

Hi Annie. I agree not all NHS teams are poor. My DN is superb and I'm really grateful that I now have her to support me with my insulin. There are various problem areas of diabetes advice that have become obvious to me both personally and thru this forum over the last few years. Diet advice is the biggest problem and is not so much due to poor nurses but due to their training. If you track this back you find the poor advice goes beyond this country even and originates from some very weak and scientifically suspect research data coming from a small number of published papers. The food industry as always lurks around in the background. Have you read today's papers regarding sugar? The National Geographic, a well respected Mag, had an article on sugar late last year describing it as a poison. Although DUK remains backward ref carbs, the American Diabetes Association has changed it's diet advice over the last year or so to be more negative about carbs and the trend continues. So my criticism of NHS db advice is that it is centrally driven and GPs/DNs are obliged to follow that advice. What has been nice over recent months is that more posters are saying their DNs have recommended a more balanced approach to the food plate. If you go back a few years the 'Eat plenty of starchy cabs' advice was very common.

 

[lizzief]

No thats not what my DN told me to do

With respect, that's not the point. You asked what advice we'd been given and I told you what mine was. Saying that you weren't told that doesn't alter the fact that I was.

 

[douglas99]

To ask again. as many posters state the nhs recommended a high carb diet, I wold be interested to know what they recommended to you.
I only ever saw the nhs one I have referred to, with a total of 175g of carbs, which was a lot lot less than my previous diet.

It's not unreasonable to ask, as it seems to be a common post in this thread, so someone must have a number they where given.(or calculated)

 

[douglas99]

With respect, that's not the point. You asked what advice we'd been given and I told you what mine was. Saying that you weren't told that doesn't alter the fact that I was.

What was the amount of carbs they told you to eat as high carb?

 

[lizzief]

What was the amount of carbs they told you to eat as high carb?

There was no figure suggested, just a lot of menu ideas that would have given a diet very high in carbs with not much room for anything else. I've just dragged the sheet out of the kitchen drawer as a reminder - one suggested breakfast was baked beans on 2 slices of wholemeal toast, followed by a banana. That's over 70g of carb to start the day with. Lunch - a large baked potato (another 25-30gm) with salad and low-fat cheese then an apple chopped into a Mullerlight yoghurt (another 14 or so for the yoghurt and 20-ish for the apple) then an evening meal of a lentil-based shepherds pie (yet another potato at 25 and around 50 for the lentils) Add in the mid-morning fruit, half pint of skimmed milk and 2 rich tea biscuits as a bedtime snack and you can add another 80g to that so we're talking a total of over 300g of carbs being an acceptable intake. I had far less than that before I was diagnosed.

 

[Thommothebear]

If I recall correctly it was that I get 1/3 of my calories from starchy foods such as (specifically) rice, pasta, potatoes and or bread. My maintenance calories for my activity lelel is 3200cals per day. By my calculation that equates to around 300g a day, which is far, far higher than I can tolerate. And much higher than I was eating on my previous or current diet.

 

[douglas99]

The most recent comment by my diabetes consultant who was initially v sceptical of Low Carb diet as she equated it with Atkins and had concerns re the amount of protein (made on the basis of the improvements seen in my bloodwork), was " low carb is the way to go, if you can stick to it, but unfortunately most of my patients cant / wont make the type of changes needed"

Absolutely spot on.
Support, advice with any possible negatives so you can be aware, and as she says, "most of my patients cant / wont make the type of changes needed"

There was no figure suggested, just a lot of menu ideas that would have given a diet very high in carbs with not much room for anything else. I've just dragged the sheet out of the kitchen drawer as a reminder - one suggested breakfast was baked beans on 2 slices of wholemeal toast, followed by a banana. That's over 70g of carb to start the day with. Lunch - a large baked potato (another 25-30gm) with salad and low-fat cheese then an apple chopped into a Mullerlight yoghurt (another 14 or so for the yoghurt and 20-ish for the apple) then an evening meal of a lentil-based shepherds pie (yet another potato at 25 and around 50 for the lentils) Add in the mid-morning fruit, half pint of skimmed milk and 2 rich tea biscuits as a bedtime snack and you can add another 80g to that so we're talking a total of over 300g of carbs being an acceptable intake. I had far less than that before I was diagnosed.

Not quite the same as they advised me, (but then I had 4 stone to lose)

baked beans on 2 slices wholemeal toast, banana
or
bacon sandwiches, 4 slices white bread and 6 rashers bacon, or maybe bacon 2 or 3 slices white toast, waffles, sausage

Potato with salad and low-fat cheese then an apple chopped into a Mullerlight yoghurt
or
chips, donut(s) chocolate bar

lentil-based shepherds pie
or
box of donuts, chips or rice, battered fish, or pie, or curry (from jar) etc

mid-morning fruit, half pint of skimmed milk and 2 rich tea biscuits
or
mid morning crisps, coffee with sugar, chocolate digestives.

So, which is better, and more to the point, what would I realistically do as a first step?

That's normally what they're working with here.

 

[Thommothebear]

Bear in mind that was 7-8 years ago, at that time there was no mention of what type of potatoes, rice, bread or pasta should be included, at least on the course I had this year they recommended new potatoes, wholegrain bread, basmati rice and wholemeal pasta. But they are still pushing porridge which I cannot cope with at all. Then theres the fruit on top of that, no mention of what kinds of fruit to avoid.