GI Data, Protein Consumption and Keto High Cholesterol

[johnb46]

Hi, I'm 73 yo, male with T2D since late 2013 diagnosis, diet controlled, BMI 22.5 and don't need to lose weight. (BP controlled to less than 140/80 by 5mg Amlodipine and cholesterol controlled at 4-5 by 20 mg statin; lifelong asthmatic, controlled well by drugs).
Grandson of a T2D, beanpole-shaped, manual worker, son of a bit overweight T2D mother, and with both siblings T2D as well.
I get plenty of exercise, in excess of 5 x 30 mins strenuous sessions per week.
I'm looking for a better, permanent diet and remisson from my T2D.
In my first year after diagnosis, I ate 2600 cals/day, keeping the carbs down to an average of 114g/day (17% carbs, 35% protein, 48% fat), much reduced from prior to diagnosis. I ate quite a lot of protein and dairy and ended up being prescribed statins because of the increase in my cholesterol levels (from 6.9/7 to 9.5, I think). I ate more carbs the next year, and my carbs have gradually risen.
My HbA1c jumped from being 41-44 during 2014 -2017 to 50 (2018) and back down to 47 in November after relatively minor diet mods. I want to see if I can get it back to where it used to be and better still.

I should like to try reducing my carbs again (to no more than 100g/day, perhaps lower) and making sure by reference to glycaemic index values that the carbs I do take on board are low GI/GL. I have a spreadsheet of GI values I found in 2014, but am concerned about its accuracy (I don't know where on the web I got it). For instance, it says avocado has only 1-2 g carbs/100g, but various sources on the web tell me it's greater than that, e.g. 8.5/9.
I am familiar with Dr Unwin's success and the infographics on phcuk/NICE websites and could work from that sort of info. But they address a relatively small number of foods, unless I have missed something.

Question A) Can somebody point to an authoritative set of GI values, please?

Given my propensity to raised cholesterol, I expect I will need to eat a high amount of protein, probably similar to or greater than the 230g/day in 2015. This didn't seem to harm me before, but seems to be way over the sorts of numbers I have seen recommended. For instance, in Jessica Turton's meta-analysis of low carb diets that is linked in this forum, no more than 2g/day per kilo, which would mean a limit of 130g/day for me. (I'm not an athlete and not a body builder. My strenuous activites are aerobic/endurance).

Question B) Is there any authoritative knowledge on whether long term, high protein consumption is OK for somebody like me?

If I improve, I'd consider a ketogenetic diet, subject to medical advice and further study.
However, I saw a statement somewhere to the effect that cholesterol can be expected to rise a little (but probably with net good effects) and it then went on to say that as many as 15% of people observe much larger rises and that, whereas medical research suppports the view that the small rises are not an issue, it doesn't say anything about the prognosis in the case of larger rises. My cholesterol went up to 9.5 my first year before I reduced my dairy consumption, so I'm concerned I may be one of the 15%.
I have a son, daughter and several grandchildren. If a ketogenic diet could get me down to something like normal, I'd dearly like to be able to give them living proof that, should it be necessary, they don't have to be prisoners of their ancestors' genetics.

Question C) Is there any authoritative quantification of what constitutes a small rise and what constitutes a larger rise in cholesterol in the context of the above and does anybody have further comment about this?

TIA
Great Forum; it has loads of useful stuff.

 

[bulkbiker]

Everything you may have ever wanted to know about the rubbish we are told about cholesterol is here...

https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/

 

[Resurgam]

Unfortunately I found that GI and GL are of little significance - my meter showed almost identical spikes caused by high or low values.
As type two diabetics, we can eat protein and fat, it is the carb controlling system which is broken.
Many people find that by eating around 50 gm of carbs a day their blood glucose and Hba1c return to normal. That also helps their metabolism return to normal, and for many cholesterol improves once their weight stabilizes. Low cholesterol doesn't seem to confer the expected benefits, however.

 

[DCUKMod]

Hi, I'm 73 yo, male with T2D since late 2013 diagnosis, diet controlled, BMI 22.5 and don't need to lose weight. (BP controlled to less than 140/80 by 5mg Amlodipine and cholesterol controlled at 4-5 by 20 mg statin; lifelong asthmatic, controlled well by drugs).
Grandson of a T2D, beanpole-shaped, manual worker, son of a bit overweight T2D mother, and with both siblings T2D as well.
I get plenty of exercise, in excess of 5 x 30 mins strenuous sessions per week.
I'm looking for a better, permanent diet and remisson from my T2D.
In my first year after diagnosis, I ate 2600 cals/day, keeping the carbs down to an average of 114g/day (17% carbs, 35% protein, 48% fat), much reduced from prior to diagnosis. I ate quite a lot of protein and dairy and ended up being prescribed statins because of the increase in my cholesterol levels (from 6.9/7 to 9.5, I think). I ate more carbs the next year, and my carbs have gradually risen.
My HbA1c jumped from being 41-44 during 2014 -2017 to 50 (2018) and back down to 47 in November after relatively minor diet mods. I want to see if I can get it back to where it used to be and better still.

I should like to try reducing my carbs again (to no more than 100g/day, perhaps lower) and making sure by reference to glycaemic index values that the carbs I do take on board are low GI/GL. I have a spreadsheet of GI values I found in 2014, but am concerned about its accuracy (I don't know where on the web I got it). For instance, it says avocado has only 1-2 g carbs/100g, but various sources on the web tell me it's greater than that, e.g. 8.5/9.
I am familiar with Dr Unwin's success and the infographics on phcuk/NICE websites and could work from that sort of info. But they address a relatively small number of foods, unless I have missed something.

Question A) Can somebody point to an authoritative set of GI values, please?

Given my propensity to raised cholesterol, I expect I will need to eat a high amount of protein, probably similar to or greater than the 230g/day in 2015. This didn't seem to harm me before, but seems to be way over the sorts of numbers I have seen recommended. For instance, in Jessica Turton's meta-analysis of low carb diets that is linked in this forum, no more than 2g/day per kilo, which would mean a limit of 130g/day for me. (I'm not an athlete and not a body builder. My strenuous activites are aerobic/endurance).

Question B) Is there any authoritative knowledge on whether long term, high protein consumption is OK for somebody like me?

If I improve, I'd consider a ketogenetic diet, subject to medical advice and further study.
However, I saw a statement somewhere to the effect that cholesterol can be expected to rise a little (but probably with net good effects) and it then went on to say that as many as 15% of people observe much larger rises and that, whereas medical research suppports the view that the small rises are not an issue, it doesn't say anything about the prognosis in the case of larger rises. My cholesterol went up to 9.5 my first year before I reduced my dairy consumption, so I'm concerned I may be one of the 15%.
I have a son, daughter and several grandchildren. If a ketogenic diet could get me down to something like normal, I'd dearly like to be able to give them living proof that, should it be necessary, they don't have to be prisoners of their ancestors' genetics.

Question C) Is there any authoritative quantification of what constitutes a small rise and what constitutes a larger rise in cholesterol in the context of the above and does anybody have further comment about this?

TIA
Great Forum; it has loads of useful stuff.

John, to be perfectly candid, I have never got too into the GI thing - for me that's all just about timing of any rise and smoothing the curve of blood sugar movements. We I to look at the curves for Low and high GI foods (and I have to an extent, whilst wearing Libre sensors), the time under the curve may differ, but the area of that,time above base is likely to be about the same. It's almost like a spike has been turned on it's side?

I've described that very poorly indeed, but I'm sort of hoping you get the gist of it.

My approach has always been to eat to my meter, and balanced against my A1c tests. Eating to my meter, I use on the basis of testing before my meal, then at set periods thereafter, and if my results satisfy me, I will continue to eat whatever I have just consumed. If they don't, I'll either eat less of it (if I really liked it), or if the numbers were really bad, subject to a confirmation test, I'd end up turning my back on that foodstuff.

Doing that brought my A1c down from 73 to 37 in around 4 months, and lower every time since. I don't mean my A1c gets lower on ever test, I mean, it has been 34, 31, 33, 27 and so on, so never about 36 since. My diagnosis was in 2013.

Regarding cholesterol. This is the usual hot potato.

For me, total cholesterol is meaningless. As a total, it's just that; what a bunch of numbers add up to. Bearing in the mind medics talk to us about "good" and "bad" cholesterol, how can a tablet whichever is designed to reduce the total necessarily help? Surely it is pushing down the supposedly good stuff along with the bad, just arriving at a different total?

For me, the breakdown of the cholesterol total is key. Whilst I always look a thing then total (my last was 7.8), I am always most interested in the triglyceride number, as they're becoming understood to be the really naughty little blighters. My last were 0.78, so a smidge up on the time before at 0.73, but not either case, not too shabby at all. Just before my blood panel, I had been overseas and eating much more tropical fruit than I usually would do, so I'm content the rise was expected really.

Finally, on to protein. I've never really spent a lot of time deciding if it's too much, or too little. I'm a pretty slight old bird, at 48kg, so that calculation you quote doesn't give me a lot of leeway.

I don't tend to lather my veggies in butter (although that has been known), so my protein is often a carrier for some of my fat. I must thinking fattier cuts like belly pork, lamb chops and so on.

I'm sure my ramblings haven't necessarily helped answer your post, but my philosophy is to get busy living. I don't turn my back on responsibility or accountability for my health. Certainly not, but for me, constant calculations or nutrient monitoring, per meal would just drive me scatty.

I hope you can find a comfortable way forward.

 

[johnb46]

Bulkbiker (very much liked your video), Resurgam and DCUKMod, thank you (a lot).
I used to be a scientist and I like to see the numbers. All Your numbers are amazing and inspirational. I hope I can follow in your footsteps.

 

[TriciaWs]

My triglycerides were a little high at diagnosis, but other cholesterol numbers with the NHS range.

Adding in extra dairy, double cream, full fat milk Greek yogurt and more cheese resulted in my triglycerides falling and other numbers remaining about the same - although my HDL was up a little. For over a year. Then total and LDL suddenly went up within 3 months.

That didn't make sense to me, although my GP fixated in my 'high fat' diet. So I checked all the research I could find and read a couple of small studies implicating another drug I'd been put on 4 months before.
I told my GP I wanted to stop that instead, and three months later the numbers had fallen - not enough to make the GP happy but fine as far as I am concerned.
It might be worth checking your list of other drugs?

(I see my notes now state 'refused statins'.)

 

[Brunneria]

Hi and welcome!

Just a query - you were eating approx 230g protein a day?
That equates to approx 9 chicken breasts, or 900g of steak.
Are you sure you are talking g of protein, not g of meat?

Like others posting above, I found the whole GI thing a red herring. For me and my body, it was the carb amount that had the impact, not whether those carbs were in wholegrain or processed white. And I always did better with potato carbs than wheat or rice carbs. Worth checking these things out with regular testing using a home meter.

My cholesterol ratios are great while eating mainly red meat and oily fish and dairy, with a small portion of 70% cocoa solid dark choc a day, but as is said so often on these boards, we are all different.

 

[Member496333]

I find GI useful for illustrating to people that things like bread and potatoes will normally cause a greater blood glucose response than table sugar. For actually managing diabetes I found it almost completely irrelevant.

 

[johnb46]

Hi and welcome!

Just a query - you were eating approx 230g protein a day?
That equates to approx 9 chicken breasts, or 900g of steak.
Are you sure you are talking g of protein, not g of meat?

Like others posting above, I found the whole GI thing a red herring. For me and my body, it was the carb amount that had the impact, not whether those carbs were in wholegrain or processed white. And I always did better with potato carbs than wheat or rice carbs. Worth checking these things out with regular testing using a home meter.

My cholesterol ratios are great while eating mainly red meat and oily fish and dairy, with a small portion of 70% cocoa solid dark choc a day, but as is said so often on these boards, we are all different.

Hi Brunneria, Yes, I'm sure, apart from occasional errors. For instance, 2 or 3 180g chicken breasts per day (40+g protein each), 1 litre of Total Fage 0% Yoghurt (100g protein), 3 or 4 eggs with a smattering of cheese and so on. My consumption, today, is quite low: 155g protein; but it's down because I ran out of chicken breasts yesterday and didn't notice.
Yes, I am gradually modifying my diet, from 160g/d late last year to a limit of 100g/d this week, but recently that has been in favour of protein because of cholesterol concerns. I shall start experimenting with some of the Keto Challenge recipes, but will check their calorific values first in case they are designed for dramatic weight loss.
An aside:-
This a.m., I looked up Mo Farah's diet (BBC interview after the 2012 games) and he apologised for how very boring it was: Frosties for breakfast, pasta and chicken for lunch and dinner, protein shakes as well. Occasionally, very dark chocolate as a treat. And he avoids eating too much pasta. No quantities, but it sound like an awful lot of protein must be involved.
His favourite food - burger; the one he had after the games was his first in a year (wot! not even a whole one for each medal?).
Cheers