Low carb diets and Diabetes UK

[2christine]

its not just about money its about my children's health your children's and ours ,how can we stand by an let these people ,just because they have done lots of good things for the diabetic patient ,be allowed to deny the earth is round .look at how the banks have become ,once were there to help, now well words fail me ....

 

[paul-1976]

It's just like a Coeliac charity advocating still eating plenty of gluten.

 

[craig81]

It's sad hearing that there has been a lack of willingness to even engage in any process of meaningful discussion on the issue to advance a deeper understanding of how people can treat diabetes. The more options available for a diverse diabetes population to treat their condition, the better.

The situation Sam faces is frankly ridiculous, but then it's not too surprising. Without wanting to sound like a conspiracy nut, dietary advice is largely based on economic interest. In fact, every decision made politically at any level is first of all a question based on economies. We had the news today of the professor recruited by the government to write recommendations on dietary sugar intake, who has admitted receiving a direct sum from coca cola to advise them on dietary advice. He then, allegedly, also receives money from Mars to help him conduct his university 'research'. This is by no means an isolated incident. The very notion of a 'balanced' diet, based on calories, was ingenuously created to allow consumption of nutritiously poor foods into our every day diets. The idea that 500 calories of cola and chocolate has the same metabolic effects on weight and body composition as 500 calories from vegetables and lean meat is ridiculous; yet this is what most people are brainwashed into thinking.

Bottom line is that people are getting sicker. Type 2 diabetes is skyrocketing. Diagnosis of type 1 is increasing year on year. Rates of autoimmunity of all conditions are increasing. Our food environment is becoming more and more toxic, and every year food companies are allowed to engage in 'voluntary regulation' to help reduce the very conditions that their products promote.

Despite this, I still have hope. People like Sam are doing tremendous work and should not become despondent. We live in an age where everlasting change comes from the bottom up. We now have places like this forum and other social media to provide the platform to inform the masses of other alternative ways of living with their diabetes, should they choose to do so. We don't have to listen to these people anymore. Just keep doing what you're doing and fight the good fight. What more can you do?

 

[smidge]

H Sam, Desi et al!

Yes, I got a similar response to my correspondence with DUK - never did manage to get a name, although I did get the impression their attitude to low carb was softening - sadly it seems I was mistaken. I was passed from pillar to post and finally gave up. I do believe though that they are the organisation to be influenced - they are the ones that can make the difference. I'm sorry your efforts have hit a brick wall so far, but please keep trying - it is essential that we somehow get DUK on message!

Smidge

 

[xyzzy]

DUK seems to be getting more and more out of date and out of touch with reality. In previous years their position statements have essentially followed those of the ADA however there now seems to be some large differences in approach. Obvious ones seem to be the ADA now recommend restricting carbs per day to around 40g per meal and have downgraded GI to a secondary technique and recommends simply reducing daily total carbohydrate (some form of carb counting) as the primary method. DUK's position statement still has the starchy carbs with every meal nonsense and advocates GI as a primary means of BG control.

Their position looks more and more arrogant and indefensible imo.

I'd love to hear their response to a question of why their position is now out of alignment with the ADA's

 

[douglas99]

DUK seems to be getting more and more out of date and out of touch with reality. In previous years their position statements have essentially followed those of the ADA however there now seems to be some large differences in approach. Obvious ones seem to be the ADA now recommend restricting carbs per day to around 40g per meal and have downgraded GI to a secondary technique and recommends simply reducing daily total carbohydrate (some form of carb counting) as the primary method. DUK's position statement still has the starchy carbs with every meal nonsense and advocates GI as a primary means of BG control.

Their position looks more and more arrogant and indefensible imo.

I'd love to hear their response to a question of why their position is now out of alignment with the ADA's

Diabetes UK recommends the following:

• A range of approaches to weight loss should be considered with the overall aim of energy intake being less than energy expenditure; the most appropriate method to achieve this should be identified between the person with diabetes and their dietitian.
• When considering a low-carbohydrate diet as an option for weight loss, people with diabetes should be made aware of possible side effects such as the risk of hypoglycaemia, headaches, lack of concentration, and constipation.
• Individual diabetes control should be considered – blood glucose levels need to be closely monitored, with adjustments to medications as required.
• Nutritional adequacy should be considered. It should be ensured that optimal amounts of vitamins, minerals and fibre are supplied by the diet.
• The amount of carbohydrate to be restricted should be agreed between the person with diabetes and their dietitian.

They also state

Low-carbohydrate diet: less than 130g per day (26%) of a 2000kcal diet

Seems to be in line with ADA

 

[Daibell]

Hi and thanks for the good and active work you have done. I am not in the least bit surprised that you couldn't move DUK on diets. I was interested in today's Sunday Times about the food industry connections of those involved in the current Sugar Watchdog. Many including the chairperson are apparently also consultants to food industries that use loads of sugar. I suspect what we have here with DUK as SamJB says is an organisation who have a lot of good people but there are also others who have there own agenda or wish to remain part of the 'Group-think' about carby diets. I have written to DUK about carbs a few times without effect, although after my last one about sugary dessert recipes in Balance these seem to have almost stopped. I believe we must all carry on lobbying them and the NHS where we see stupidity at work and little by little we will see changes

 

[phoenix]

actually the ADA have moved towards acceptance of the GI; they used to hate it!

The European dietary guidelines are in the process of revision and I suspect that what they write will have an influence on any revision of the UK guidelines.
I've put this link in before . It is a lecture at this years EASD conference from the chairman of the nutritional committee , Prof Jim Mann, a New Zealander. He gives some of the rationale/evidence behind the present carbohydrate recommendations together with some more recent evidence.He suggests that the guidelines on carbs will probably not change much in the forthcoming revision but he feels that they have been misinterpreted in some quarters. (including by implication the NHS/DUK whose advice is quoted on the first slide)

http://www.easdvirtualmeeting.org/resources/6543
PS I'm sure there will be apoplexy in some quarters when he cites a study where the high carb was 65% and the low carb 48%(albeit favourable towards the 'low carb' arm ) but please persevere. He goes on to discuss the difference between weight loss and weight maintenance (something both the ADA and DUK refer to. He then goes on to discuss the quality of carbs, something I think that DUK doesn't address (ie it's legumes and whole grain rye for preference, not fluffy white rice and bagels, pudding or mountains of white pasta (white pasta, relatively low GI but poor nutritional quality)

so maybe we should be seeing more of this type of picture (along with portion size, my dietitian is brilliant at cutting thin slices ) He describes both the white and the so called whole grain bread as bags of glucose. (and yes, I agree!)

 

[xyzzy]

Diabetes UK recommends the following:

• A range of approaches to weight loss should be considered with the overall aim of energy intake being less than energy expenditure; the most appropriate method to achieve this should be identified between the person with diabetes and their dietitian.
• When considering a low-carbohydrate diet as an option for weight loss, people with diabetes should be made aware of possible side effects such as the risk of hypoglycaemia, headaches, lack of concentration, and constipation.
• Individual diabetes control should be considered – blood glucose levels need to be closely monitored, with adjustments to medications as required.
• Nutritional adequacy should be considered. It should be ensured that optimal amounts of vitamins, minerals and fibre are supplied by the diet.
• The amount of carbohydrate to be restricted should be agreed between the person with diabetes and their dietitian.

They also state

Low-carbohydrate diet: less than 130g per day (26%) of a 2000kcal diet

Seems to be in line with ADA

Nope. Look here on their position statements pages

http://www.diabetes.org.uk/About_us...ydrate-diets-for-people-with-Type-2-diabetes/

The page includes a specific reference to how much carbohydrate should be consumed on a 2000kcal diet

How much carbohydrate is in a low-carbohydrate diet?
For a 2000kcal diet, the recommendation for carbohydrate is 225–300g per day (45–60%)

or here http://www.diabetes.org.uk/About_us...tion-of-carbohydrate-in-people-with-diabetes/

which is again on their position statement pages

How much carbohydrate do you need?
The guidelines daily amount (GDA) for carbohydrate is 230g for women and 300g for men. These are general guidelines: the actual amount of carbohydrate that the body needs varies depending on your age, weight, and activity levels. The amount of carbohydrate eaten or drunk is the major factor in blood glucose control and therefore portion sizes are important. The advice provided by Diabetes UK is for the general population with diabetes; it does not replace individual advice from a healthcare professional.

The first quote comes from their position statement on carbohydrates for people with T2 (2011) and the second quote on general consumption of carbohydrate for diabetics (2012)

There is no equivalent ADA type statement that says "consume around 40g per meal" anything but!

 

[xyzzy]

actually the ADA have moved towards acceptance of the GI; they used to hate it!

The European dietary guidelines are in the process of revision and I suspect that what they write will have an influence on any revision of the UK guidelines.

Well lets hope the European health guidelines are influenced by the Swedes but I seriously doubt the (D)UK will take any advice from Europe!

Those diabetes experts at the ADA do now seem to be making a bit of sense at least on the importance of carbohydrate quantity consumed. It's quite refreshing to be on the side of the recognised world experts for a change! Here's the latest ADA recommendations updated just a few days ago.

GI or Carbohydrate Counting?
There is no one diet or meal plan that works for everyone with diabetes. The important thing is to follow a meal plan that is tailored to personal preferences and lifestyle and helps achieve goals for blood glucose, cholesterol and triglycerides levels, blood pressure, and weight management.

Research shows that both the amount and the type of carbohydrate in food affect blood glucose levels. Studies also show that the total amount of carbohydrate in food, in general, is a stronger predictor of blood glucose response than the GI.

Based on the research, for most people with diabetes, the first tool for managing blood glucose is some type of carbohydrate counting.

Because the type of carbohydrate can affect blood glucose, using the GI may be helpful in "fine-tuning" blood glucose management. In other words, combined with carbohydrate counting, it may provide an additional benefit for achieving blood glucose goals for individuals who can and want to put extra effort into monitoring their food choices

- See more at: http://www.diabetes.org/food-and-fi...-index-and-diabetes.html#sthash.cVOlcBEy.dpuf

Roll on the day DUK states something in simple plain English as that!

 

[douglas99]

..........................There is no equivalent ADA type statement that says "consume around 40g per meal" anything but!

That's the problem with a lot of the information provided to support low carbing.

Statements that seem to be a fact, when quite simply they aren't. It undermines everything put forward.

Following your own link in your very next post, the ADA clearly state.

"A place to start is at about 45-60 grams of carbohydrate at a meal. You may need more or less carbohydrate at meals depending on how you manage your diabetes."

http://www.diabetes.org/food-and-fi...ding-carbohydrates/carbohydrate-counting.html

So once you start posting "facts" which are easy to check, it brings all the arguments into dis-repute.

The Swedish diet is another example, it's a diet for short term, for weight loss.
It's not a way of life, and even the doctors who did the study have had to correct the mis-quotes it's had.
The title was "Dietary Treatment for Obesity" It was for weight loss.
It's a portion restricted diet, suggested to eat only two meals a day.

""If you can, skip [breakfast]! This is a habitual behavior, the body has no need for nourishment the minute you get out of bed if you've eaten a high-fat dinner the day before. We make our own glucose from stored protein, and it probably costs a few calories to produce this glucose, which can be one reason why a low-carb diet provides great weight loss. Also, skip snacks and any low-fat products. If we were meant to nibble on low-fat foods all day we wouldn't have been equipped with a gall bladder. If you eat two meals daily, with few carbohydrates and plenty of good fats, you'll do just fine. Do like the Mediterranean people. Let a cup of coffee be your breakfast in the morning."

http://www.healthnewsdigest.com/news/contributing columnist0/Sverige-Speaks-We-ve-Found-The-Best-Diet_printer.shtml

 

[phoenix]

Nystroms breakfast study used a Mediterranean diet for the coffee/ lunch arm.
http://www.sciencedaily.com/releases/2013/11/131128103839.htm
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0079324

 

[mo1905]

I'm surprised the avg carbs for men is 300g a day ! That's huge !

 

[mpe]

The Care Team seem to be made up of a bunch of dieticians, so this was a tall order. In the end I managed to get their statement on low carb diets for Type 1s changed from, succinctly, "there is no published evidence that it works", to "there is no published evidence that it works, but we know some Type 1s use it to control their levels". I couldn't get anywhere with persuading them to change their advice on Type 2s. You can see the full statement here: http://www.diabetes.org.uk/About_us/What-we-say/Food-nutrition-lifestyle/Consumption-of-carbohydrate-in-people-with-diabetes.

Is it necessary for dieticians to understand either biology or chemistry?
I spotted several errors in one paragraph.
1) The small intestine takes in glucose, fructose and galactose from dietary carbohydrates. Not exclusivly glucose.
2) At least glucose and fructose are present in many foods, thus don't need "breaking down", in the first place.
3) The only cells which "need" glucose are those without mitochondria, the greatest number of these being red blood corpuscles. (These cells produce pyruvic acid, which is a ketone.)
4) Confusion to ketosis, a normal metabolic process observed in several species of mammals and birds, with ketoacidosis. (Glucose is also toxic when there is too much of it in the blood. Since blood plasma is a "buffer solution", it requires rather a lot of anything to change blood pH.)
5) The most common form of respiration of fats is "beta oxidation" which takes place inside mitochondria and has nothing to do with ketosis.

It's also well proven that humans don't actually need dietary carbohydrates in the first place...

 

[mpe]

The Care Team want us to control our diabetes via a "healthy balanced diet" and they do have our best interests in this. The stat of 93% and 75% of Type 1s and 2s not achieving the HbA1c target of 6.5%, strongly suggests that this is not working.

The diet they advocate one very high in glucose. I've yet to hear an explanation of how it could possible "work" in the first place.

 

[xyzzy]

That's the problem with a lot of the information provided to support low carbing

Whatever

It would appear you are the one that has a problem with other people's regimes by constantly being critical of any that are different to what you think should be followed. It begs the question why.

Do you honestly think that the 1000's of forum members over the years who have done some form of restricted carbohydrate regime and got the results they've stated are all liars? How arrogant is that?

If you weren't so critical of other people's choices then I and others wouldn't have to defend them.



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[Daibell]

I wonder how many of the Care Team staff have professional qualifications? By that I mean something like degree level training in a subject including an understanding of the scientific method, human biology and so on. They may not all have that level of training but I would expect all of the leaders/managers to have. I can find no trace of staff names on the DUK website other than the chair etc which I find surprising in such a high profile and important charity. Perhaps as forum we need to point people to the ADA website when relevant as an authoritative body and bypass DUK on dietary matters?

 

[douglas99]

Whatever

It would appear you are the one that has a problem with other people's regimes by constantly being critical of any that are different to what you think should be followed. It begs the question why.

Do you honestly think that the 1000's of forum members over the years who have done some form of restricted carbohydrate regime and got the results they've stated are all liars? How arrogant is that?

If you weren't so critical of other people's choices then I and others wouldn't have to defend them.



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None of this is relevant to the discussion. Your desire to insult me because I pointed out you were posting misinformation is another problem with convincing people you have a valid argument.
People respond to factual, considered, truthful data, not opinions, misquotes, then insults.
What you said about the ADA was simply not true, I pointed that out, gave you the correct links, then you decide insults will work instead?
I always said, I have no problems with anyone deciding to LC, I probably will one day.
I have a problem when you decide to make up facts to prove I should now.
Not with low carbers, not with low carbing, just with mis-information relating to it.

 

[fatbird]

douglas said.

"I always said, I have no problems with anyone deciding to LC, I probably will one day."

Sooner is always better than later. Reduce medication and preserve the pancreas.

FB

 

[xyzzy]

None of this is relevant to the discussion. Your desire to insult me because I pointed out you were posting misinformation is another problem with convincing people you have a valid argument.
People respond to factual, considered, truthful data, not opinions, misquotes, then insults.
What you said about the ADA was simply not true, I pointed that out, gave you the correct links, then you decide insults will work instead?
I always said, I have no problems with anyone deciding to LC, I probably will one day.
I have a problem when you decide to make up facts to prove I should now.
Not with low carbers, not with low carbing, just with mis-information relating to it.

..
and your original statement claiming DUk advocates a 130g regime was true was it! Just an innocent mistake on your part with no motive attached to it what so ever...

I gave links to my facts showing your assertion was wrong and you got p****d off is probably nearer the truth.

You cannot deny that the information that the ADA think GI is secondary to carb counting is a fact the link I posted clearly comes from their site.

It is perfectly true that the Swedes advocate a range of restricted carb regimes in their national health care document "Kost Vid Diabetes" They even accept ketogenic regimes under hcp supervision so I have nothing to retract there.

I also know many T2 diabetics who sit happily in that 120 to 180g range advocated by the ADA as well as many who have to do less. The point is even 180 is far less than the 300g a day that DUK states is the requirement in the position statements I gave links to.

Bored of your games now...



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