LCHF and the NHS

[SJC]

I got to thinking today about the NHS and the way they advise about diabetes and diet. I know a lot of you have had great success with the LCHF diet and I am following it, but how many of you have told your doctors, clinic etc about how you have kept your BG levels down? I have to see the dietician at the hospital soon because I am losing weight and need to keep it on. Do you reckon she is going to tell me to increase my carbs because I do? How else can I put weight on?

This LCHF affair...is it tried and tested over a long time? If it is and has had such successful results, why do you think the NHS hasn't picked up on it and advised people to take it up?

 

[mo1905]

The NHS is a bit of a dinosaur and things mover very slowly. However, we've recently been hearing of more and more advice agreeing with reducing carbs, which is a good thing.

 

[SJC]

The NHS is a bit of a dinosaur and things mover very slowly. However, we've recently been hearing of more and more advice agreeing with reducing carbs, which is a good thing.

My doctor told me to reduce carbs but he didn't mention anything about fats at all.

 

[mo1905]

That's because it's carbs that raise BG levels. Trouble is with LCHF is there are so many different opinions what it actually means. Get a diet that suits your lifestyle/taste and BG levels. Do this by testing regularly. A doctor can't advise you on this. You need to find out yourself. Your version of acceptable LCHF diet will be different to a lot of others. Good luck, Mo

 

[SJC]

Thanks mo. That's what I am doing. It has generally speaking got a good success rate for BG levels, if the forum is anything to go by.. My point was why don't dieticians, diabetic nurses, and GPs know this? Maybe I am missing something here.

 

[kesun]

how many of you have told your doctors, clinic etc about how you have kept your BG levels down?

As I've mentioned elsewhere in this forum, my DN thought LCHF a great idea but suggested I could improve it by reducing fat and increasing fruit. To me, increasing carbs and lowering fat rather takes away the point of LCHF - but at least she didn't foam at the mouth at the mere mention of LCHF, so I suppose it's a start.

I have to see the dietician at the hospital soon because I am losing weight and need to keep it on. Do you reckon she is going to tell me to increase my carbs because I do? How else can I put weight on?

I find that if I play around between protein and fat (while keeping off the carbs) I can control my weight: more fat and less protein and I lose weight, more protein and less fat and I gain. I've no idea whether this is a common response.

Kate

 

[mo1905]

Some know, some don't ! Some are changing slowly. However, the best advice is to experiment and test a lot to work out what suits you best.

 

[SJC]

As I've mentioned elsewhere in this forum, my DN thought LCHF a great idea but suggested I could improve it by reducing fat and increasing fruit. To me, increasing carbs and lowering fat rather takes away the point of LCHF - but at least she didn't foam at the mouth at the mere mention of LCHF, so I suppose it's a start.

I find that if I play around between protein and fat (while keeping off the carbs) I can control my weight: more fat and less protein and I lose weight, more protein and less fat and I gain. I've no idea whether this is a common response.

Kate

Thanks Kate. Sadly I can't have too much protein because of kidney disease.

 

[AlexMBrennan]

is it tried and tested over a long time? If it is and has had such successful results, why do you think the NHS hasn't picked up on it and advised people to take it up?

It's "obviously" "common sense" to non-medically-trained people and supported by lots of happy customer testimonials and best selling books but sadly next to no admissible research which the NHS could base a decision on.

 

[Scandichic]

I got to thinking today about the NHS and the way they advise about diabetes and diet. I know a lot of you have had great success with the LCHF diet and I am following it, but how many of you have told your doctors, clinic etc about how you have kept your BG levels down? I have to see the dietician at the hospital soon because I am losing weight and need to keep it on. Do you reckon she is going to tell me to increase my carbs because I do? How else can I put weight on?

This LCHF affair...is it tried and tested over a long time? If it is and has had such successful results, why do you think the NHS hasn't picked up on it and advised people to take it up?

There has been lots of research which has proven LCHF but the NHS doesn't want to listen. The argument being that only HCP know what's what. This is why they won't listen. Trouble is, some of the LCHF material is written by docs too. However, some of them are foreign so xenophobia kicks in and the info is disregarded. I think that www.dietdoctor.com gives the best explanation I have ever read but despite being a doctor who specialises in obesity and diabetes he has committed the mortal sin of being Swedish - lol! Good luck!

 

[SJC]

It's "obviously" "common sense" to non-medically-trained people and supported by lots of happy customer testimonials and best selling books but sadly next to no admissible research which the NHS could base a decision on.

Now that I can understand as they have to base everything on clinical research. I saw something on TV yesterday about side effects of statins. Saying that some medical journal had got their figures wrong. They had said there were more people suffering side effects than there actually was. A London cardiac doctor was asked if people should be warned about the side effect of statins and she said that those at risk should not stop taking their statins and that she gives them out happily every day. She also intimated that they are sometimes given out prematurely.

 

[SJC]

There has been lots of research which has proven LCHF but the NHS doesn't want to listen. The argument being that only HCP know what's what. This is why they won't listen. Trouble is, some of the LCHF material is written by docs too. However, some of them are foreign so xenophobia kicks in and the info is disregarded. I think that www.dietdoctor.com gives the best explanation I have ever read but despite being a doctor who specialises in obesity and diabetes he has committed the mortal sin of being Swedish - lol! Good luck!

Hi...thanks. I shall take a read of that.

 

[Spiker]

It is a fair point that the NHS does need clinical evidence before they can change their advice. The unfair irony is that the advice they give today is not evidence based at all, it's basically a very large guess that turned out to be wrong. There is massive, clear evidence that this is the case. But there is not yet a mass of evidence to prove, large scale, that LCHF is a valid alternative (obviously the entire country of Sweden as a laboratory doesn't count! ;-) )

In my experience I have found almost all dieticians to be fiercely resistant and condemnatory, throwing out a lot of fear. These dieticians are (in my experience) universally unable to argue their position from evidence. Which is not surprising as there is no evidence in favour of high carb diets and plenty of evidence against, and no evidence in favour of low fat and plenty of evidence against. The dieticians show that they are not evidence based HCPs and are basically dogma-based, learned it once and never change. The sad thing is that due to the specialisation of the medical profession, nurses and doctors generally defer to dieticians on diet issues, even within their own specialism of diabetes. So if comes to an argument between a patient and a dietician, the nurse or doctor will tend to side with the dietician.

Having said that I have been lucky enough to work with one or two dieticians who are quite open minded and willing to be convinced by academic evidence and also by practical experience, eg seeing what happens. I am looking forward to showing them a significant HBa1c reduction. They will probably claim it's the pump. But then a look at the Diasend data on the pump before and after low carbing will make it clear that it's the low carbing that caused the (hoped for!) reduction in HBa1c. Hopefully from 9.7% to 7.6% in ten weeks. And only low carbing for the last 3-4 weeks of that.

 

[phoenix]

There has been lots of research which has proven LCHF but the NHS doesn't want to listen. The argument being that only HCP know what's what. This is why they won't listen. Trouble is, some of the LCHF material is written by docs too. However, some of them are foreign so xenophobia kicks in and the info is disregarded. I think that www.dietdoctor.com gives the best explanation I have ever read but despite being a doctor who specialises in obesity and diabetes he has committed the mortal sin of being Swedish - lol! Good luck!

But the Swedes couldn't find it either:

The absence of sufficient-quality studies in people with diabetes prevents evaluation of the long-term effects of more extreme diets involving low-carbohydrate and high-fat intake, eg, so-called “low-carb, high-fat” (LCHF) diets. Hence, safety aspects become particularly important in clinical follow-up of individuals who choose extreme low-carbohydrate diets (10–20% energy from carbohydrates).

http://www.sbu.se/upload/Publikationer/Content1/1/mat_diabetes_eng_smf_110517.pdf
(or the Canadians or the Yanks or the French or even the Europeans though their guidelines are a bit old and in the process of development.)
Do you think that guidelines should be developed on anecdote? Which accounts should they take note of, which doctors?
How about this story from the (Dr) McDougall blog http://www.drmcdougall.com/health/education/health-science/stars/stars-written/jason-wyrick/
His diet is a ' low-fat, high-fiber, plant-based diet based around starches with the addition of fruits and vegetables'
(and no I don't think they should use this for evidence either)

 

[kesun]

There has been lots of research which has proven LCHF but the NHS doesn't want to listen. The argument being that only HCP know what's what. This is why they won't listen. Trouble is, some of the LCHF material is written by docs too. However, some of them are foreign so xenophobia kicks in and the info is disregarded. I think that www.dietdoctor.com gives the best explanation I have ever read but despite being a doctor who specialises in obesity and diabetes he has committed the mortal sin of being Swedish - lol! Good luck!

And then there's Dr Bernstein, of course - but he's only an engineer who re-trained as a doctor, and what's more he's clearly prejudiced by being a diabetic himself!

But I think that we have to leave the HCPs to their own opinions and do what works for us. My personal opinion is that there's less research to support statins than there is to support LCHF, but again my opinion isn't relevant to what works; and for me, I'm a healthier person with near-normal blood sugar since starting on LCHF.

Kate

 

[Spiker]

But the Swedes couldn't find it either:

http://www.sbu.se/upload/Publikationer/Content1/1/mat_diabetes_eng_smf_110517.pdf
(or the Canadians or the Yanks or the French or even the Europeans though their guidelines are a bit old and in the process of development.)
Do you think that guidelines should be developed on anecdote? Which accounts should they take note of, which doctors?
How about this story from the (Dr) McDougall blog http://www.drmcdougall.com/health/education/health-science/stars/stars-written/jason-wyrick/
His diet is a ' low-fat, high-fiber, plant-based diet based around starches with the addition of fruits and vegetables'
(and no I don't think they should use this for evidence either)

I cry FUD(*), phoenix. What you quoted is not contradicting beneficial effects, not contradicting that there's no good evidence for low fat / high carb, not contradicting that there is good evidence for beneficial effects of low carb / high fat. It's just raising a fear of an unknown. Every new therapy suffers from this problem. When low fat / high carb was introduced, there was similarly, no evidence at all on long term risks (ignoring the fact that there was no evidence on short term benefits either!). Every single therapy that is introduced, is initially introduced in the absence of evidence on long term risks. If that wasn't the case, nothing would ever get introduced and nothing would ever change, because it's a chicken and egg problem.

I think what we are seeing in the NHS is frustrating for some (me included) but reasonable. They are conservative, and they are slowly moderating their opinion, as evidence slowly builds up in favour of low carb and evidence builds up against low fat. We would not want them to change national policy on a knee jerk reaction, so a bit of conservatism is appropriate.

* FUD = Fear, Uncertainty and Doubt. Deployed to support the status quo and oppose change, without any base in evidence. Developed by IBM to preserve their near-monopoly dominance of the computer hardware market. (Of course that worked well for them in the end...)

 

[Totto]

But the Swedes couldn't find it either:

http://www.sbu.se/upload/Publikationer/Content1/1/mat_diabetes_eng_smf_110517.pdf
(or the Canadians or the Yanks or the French or even the Europeans though their guidelines are a bit old and in the process of development.)
Do you think that guidelines should be developed on anecdote? Which accounts should they take note of, which doctors?
How about this story from the (Dr) McDougall blog http://www.drmcdougall.com/health/education/health-science/stars/stars-written/jason-wyrick/
His diet is a ' low-fat, high-fiber, plant-based diet based around starches with the addition of fruits and vegetables'
(and no I don't think they should use this for evidence either)

Moderate low carb is one of several accepted ways to treat diabetes in Sweden. Further more HCPs are required to give advice on LCHF should you choose this path yourself; they cant (yet) recommend LCHF but must give advice on how to do it..

 

[Spiker]

Moderate low carb is one of several accepted ways to treat diabetes in Sweden. Further more HCPs are required to give advice on LCHF should you choose this path yourself; they cant (yet) recommend LCHF but must give advice on how to do it..

And as it says in Mr Dr Diet Doctor guy's talk, they did have the issue examined by their Vulcan Science Council or whatever it's called, their equivalent of NICE, which pronounced LCHF as acceptable, after looking at all the extant information over 2 years. So it's reasonable to assume that the Swedish Brains Trust has conducted a decent meta-review and were not just smoking herring.

(the link is timecoded to where he talks about Sweden)
(no it isn't, sorry, the forum software ate the timecode. It's at about ten minutes in)

 

[Scandichic]

But the Swedes couldn't find it either:

http://www.sbu.se/upload/Publikationer/Content1/1/mat_diabetes_eng_smf_110517.pdf
(or the Canadians or the Yanks or the French or even the Europeans though their guidelines are a bit old and in the process of development.)
Do you think that guidelines should be developed on anecdote? Which accounts should they take note of, which doctors?
How about this story from the (Dr) McDougall blog http://www.drmcdougall.com/health/education/health-science/stars/stars-written/jason-wyrick/
His diet is a ' low-fat, high-fiber, plant-based diet based around starches with the addition of fruits and vegetables'
(and no I don't think they should use this for evidence either)

I will try and dig out the post where all of the research docs are listed. There is plenty of evidence but I am not convinced that you really want to hear it.
I do not need to listen to anecdotal evidence. I can sit here and smile smugly as I look at my own results.

 

[SJC]

I think it's great that LCHF is working so well for so many on this forum. I don't trust easily by nature having been let down a lot in the past by doctors/hospitals. I have lost my confidence in good solid advice in medical terms. I will give you just one tiny example:

I was told by an urology registrar when I had my kidney removed, that I wasn't to take any painkillers at all, only in absolute extreme circumstances. I asked about paracetamol and he said no not really. He said if you can manage without please do. About a year later I ended up in casualty with pain. The casualty consultant asked if I wanted some paracetamol. I said 'Well, I'm not really supposed to have it because of kidney disease'. He laughed and said, paracetamol is digested by the liver not the kidneys and promptly fetched me a couple. It's the same with Gaviscon for my acid. I have been told strictly by the hospital not to take it because of the sodium content. My GP? Take it, he says, just don't overdo it.

See? You get such conflicting advice from doctor to doctor. When this happens a lot to you, you start to lose confidence in their judgement, knowledge and ability.

When I first read about the LCHF diet on here I was alarmed but because I have spent many years being told to low fat everything. When I think about it even now, lard, butter, full fat this and that, was apparently causing heart attacks for many years gone by. We apparently live longer now, so that leads me to think that fatty meat etc was causing health problems. It could be of course that we are living longer with the advance of new medications, but it's just a thought I had.

If it aint broke don't fix it....I know. LCHF is working for so many people where BG is concerned, and I guess that's all that matters in the long run,