NHS Healthier You diabetes prevention programme

[Zeppx]

This somewhat overlaps with a post I have just added to the November 2024 thread on the same topic.

I have just been invited to join the NHS Healthier You 9-month programme. This happened a year or two ago too, and I did not follow the programme after finding out it was based on the Eatwell Plate and would have meant reporting all the things I normally log on my iPhone and Apple Watch already - thus double effort.

The programme now (March 2025) describes itself as follows:

Flexible options with a choice of face-to-face, remote or digital support. Tailored guidance from our team of coaches, specially trained in behaviour change. Regular sessions providing support and building knowledge and skills. Bonus resources like articles, recipes and a journal to track your progress. Access to our online gym offering yoga, armchair aerobics, circuits and more.

Has anyone tried the programme recently? I am curious about the "online gym", which actually sounds like a bit more than online videos.

But from reading the November 2024 thread I see that others have had mixed experiences of the programme and that the Freshwell Low Carb Project is recommended and looks really useful. I think I will recommend it to my GP.

 

[Chris24Main]

What do you think? Are you tempted this time round?

 

[Chris24Main]

Had a scan over the advice for how to eat if you are prediabetic.
Some good advice, and on the whole, better than I expected, but some things that at least I know just don't gel with my experience.

1. "Fats containing saturated fat raise the fat levels in our blood" - well that seems to make sense:

except that isn't how it works. It isn't even mentioned at all on the entire page, but fat is a perfectly viable source of energy, and the amount in your blood is tightly regulated depending on how you eat. If you eat more sugar and starch than you can burn or store (which isn't much) you will turn that into a type of saturated fat. Fats are really complex. For me, the fat in my blood shot right over the top of the measurement scale because I was eating too many grapes and honey.

2. "Bread, pasta, rice, potatoes, chapattis, plantain, starchy veg, sugar and flours all contain carbohydrate. This is broken down into glucose and used by our cells as fuel."

Bit of a misrepresentation. Even according to the American Academy of Sciences 2005, the body that leads on daily limits:

"the lower limit of dietary carbohydrate compatible with life is apparently zero provided that adequate amounts of protein and fat are consumed."

You do need some glucose for energy, but you can make all the glucose you need for energy yourself. The amount you need to eat is zero. Everything else is choice.

3. "can be one of your 5 a day" - the 5 a day thing was never real. You can eat what you like, but there was never any science that suggested 5 a day was beneficial, it was just assumed.

4. "Fats that are considered healthy are known as unsaturated fats"

That's a terribly old narrative and just doesn't make sense. Nearly half of beef fat is unsaturated. Sauerkraut is full of saturated short chain fatty acid, but saturated nonetheless. The most highly saturated fat comes from coconuts.

Fats are complex, and all food contains a mix of different fat. However, we are made primarily from fat and protein, and our brains are mainly fat, so maybe demonising a category of fat that humans have eaten for the entirety of human history isn't such a good idea.

Also, maybe replacing that with industrially refined oils as a huge proportion of our diet, when there really isn't any science to suggest that's a good thing - maybe that we should think about.


....
But like I said, not as bad as I was worried about.

 

[Zeppx]

Had a scan over the advice for how to eat if you are prediabetic.

What are you quoting - is this the Freshwell site or the NHS one? Sorry, my brain is a bit full at the moment.

 

[Chris24Main]

How to eat if you’re prediabetic < Healthier You

It can be difficult to know what’s best to eat, without having to consider prediabetes and being a healthy weight. A healthy, balanced diet with an emphasis on foods and eating behaviours that don’t cause a spike in blood sugars is best for us all to follow. Each of the macronutrients (carbs...

healthieryou.org.uk

The Freshwell info on the other hand - I suppose I should say the Freshwell Low Carb project info, I found last time l looked to be pretty spot on.

 

[Zeppx]

What do you think? Are you tempted this time round?

I'm not tempted but will not decide today. I have read more on that Healthier You site and see there are three options: online with Zoom, which sounded interesting but is for people who have particular reasons not to handle "digital" or have poor English, so that's not me; a local face-to-face group; and digital, which apparently is Second Nature. I must say that I did try Second Nature when it was called Our Path and I hated it! Perhaps I should state that I get very angry about things. Someone in the other thread who found it OK was given digital scales etc. Well, I've got digital scales already, I have had them since at least 2012 - I'd forgotten they do that. I remember we had a little online chat group and I felt that the members were not quite honest (me being nasty again): there was a lady who did everything perfectly, had lots of ideas about food, praised the programme throughout and lost masses of weight - although it turned out she had three children and they had formerly lived on takeaways - so no wonder she lost weight. The same goes for all sorts of programmes - there are people there who have not thought much about obesity or diabetes before. We are all different.

I do not know what the face-to-face group would be like, possibly led by someone only recently trained up for the role, but it's the only way I could do the programme.

How to eat if you’re prediabetic < Healthier You

It can be difficult to know what’s best to eat, without having to consider prediabetes and being a healthy weight. A healthy, balanced diet with an emphasis on foods and eating behaviours that don’t cause a spike in blood sugars is best for us all to follow. Each of the macronutrients (carbs...

healthieryou.org.uk

The Freshwell info on the other hand - I suppose I should say the Freshwell Low Carb project info, I found last time l looked to be pretty spot on.

(Replying to the second message) Well, I am fairly ignorant but I wondered about them saying olive oil and butter are best. Zoe says olive oil is so good for you there are no downsides. I don't think it's keen on butter. But it is relenting a bit on seed oils lately. I even possess a bottle of sunflower oil, but I forget why. I usually use olive oil. You know more about saturatedunsaturated than I do.

I have reached a point where I very much need to lose weight and I don't like te idea of weight jabs. I might need some kind of counselling to avoid snacks, not sure yet. I am mobidly obese and over 70 and all my health problems could be alleviated if I lost weight. But losing weight and improving my HbA1c score are not incompatible.

 

[Chris24Main]

OK - I hear you...

(I couldn't have told you what unsaturated actually meant a year ago, so don't feel like this is some kind of secret society here; simply that much of what we've been led to believe all our lives turns out not to have been great advice).

Do you have any sense of what would work for you.?

(I'd suggest trying whatever you can not to get very angry very often, by the way - that will drive up your blood glucose like nobody's business)

 

[Zeppx]

I have been trying to eat a lot of protein and fibre. (Zoe constantly gave me fat warnings so I try not to use masses of olive oil). The recommended breakfast of 5% Greek yogurt with frozen fruit and fibre, plus some chicken breast for even more protein, a small black coffee and maybe an apple - seems to be OK. Then I want to avoid snacks most of the time. Whether to have three meals or two plus a snack I have not yet decided. TRE works to some extent. I remember reading in Jason Fung that there's a lot to be said for eating nothing, because everything you eat does something to your insulin! I think I will have to scale down the amount of protein recommended for obese old women, as it seems a bad idea to eat three large meals to get it.
I was about to come to a decision about an eating plan after I went away for a week in February but when i came back I was diagnosed with cellulitis in one leg, where I also have lymphoedema, and am on the third of four weeks of 500 mg antibiotics that have to be taken every 6 hours on an empty stomach so this has made things difficult.
With the NHS stereotyped advice coming in and getting a copy of Dr Rupy's new book allegedly on high-protein food but actually a huge bizarre collection of ideas (gut health and inflammation, telling me to imagine a barbecue in the forest) I will probably continue resting with my legs elevated and try to think about something else.
I have eaten reasonably well today, however, I am allowed to eat something again between about 19.00 and 22.00, probably fish and vegetables.

I think what annoys me most of all is advice that seems to assume I know nothing and feels infantilizing. From people, or bots, who think they know exactly what my problems are.

I will feel better if I go swimming again and to the gym - it's hard to decide with cellulitis when it'sa good idea to do this.

 

[MrsA2]

I'm booked on to a local face to face one that starts end April.
First contact was mid December so they don't rush to get you started.
I'm not expecting much
Thought it would be interesting to meet others local
Just being nosy really
Was surprised how much time and duration! Do they think have nothing better to do.?
I'm not expecting to complete it and I certainly won't follow any advice I disagree with.
(5 years diagnosed. 5 years low carb, normal weight and BP, physically active)

 

[Zeppx]

I'm booked on to a local face to face one that starts end April.
First contact was mid December so they don't rush to get you started.
I'm not expecting much
Thought it would be interesting to meet others local
Just being nosy really
Was surprised how much time and duration! Do they think have nothing better to do.?
I'm not expecting to complete it and I certainly won't follow any advice I disagree with.
(5 years diagnosed. 5 years low carb, normal weight and BP, physically active)

That's brilliant and I think I will do the same. No reason not to try it just because I have low expectations (for some reason I always feel guilty about that). Thank you.

 

[Zeppx]

I've booked the face-to-face group. It starts on April 2nd when I talk to someone on the phone for 20 mins. After that, there are a number of two-hour group sessions.

 

[Neeny84]

The course is rubbish. I'm doing the online one. I was told to add a drizzle of olive oil to my food if I find I'm hungry after meals.
I cant see how a drizzle of olive oil will prevent me being hungry an hour after eating.
Recipes are claiming to be carb free but do include carbs.
I've found nothing helpful at all.

 

[Melgar]

The course is rubbish. I'm doing the online one. I was told to add a drizzle of olive oil to my food if I find I'm hungry after meals.
I cant see how a drizzle of olive oil will prevent me being hungry an hour after eating.
Recipes are claiming to be carb free but do include carbs.
I've found nothing helpful at all.

I'm not sure a drizzle of olive oil would be sufficient to stop a blood sugar 'spike' after consuming carbs, but fat in general does slow down the metabolization of foods thereby helping to lower blood sugar spikes. Fibre and protein will also help prevent blood sugar spikes after carby meals.

I have attached a link to how fats affect blood sugar. If you scroll down to How does fat affect blood sugar? there is brief explanation. Not the best link, but it does confirm this process.

https://www.vively.com.au/post/the-...P-_UqzeqSURbgT3KOyXjVo26OO8-iioMIItXvQEq87Gf3


Edited to add the last sentence and link.

 

[Zeppx]

The course is rubbish. I'm doing the online one. I was told to add a drizzle of olive oil to my food if I find I'm hungry after meals.
I cant see how a drizzle of olive oil will prevent me being hungry an hour after eating.
Recipes are claiming to be carb free but do include carbs.
I've found nothing helpful at all.

Which course are you doing? Is it Second Nature or what provider? I thought of doing it online a couple of years ago - this was not Second Nature but Ovivo (?) - but it turned out that I would have to log every detail of my life including every 200ml of water I drank, and as I already log everything anyway, I would have had to do it twice.

I had the first meeting of the face-to-face group last week. I was pleasantly surprised in that the trainer (?) was not at all prescriptive. Perhaps she was not prescriptive enough. It was useful to meet a lot of other people and to have some questions and discussion. I will definitely go again.

We were given a "wellbeing journal" with over 200 pages of all sorts of things. On the cover it says "Jot down your weight or something else you're proud of after each session". Some of the later pages have a feel-good quote at the bottom. One page says "Putting yourself first may be something you've never done before". This isn't me.

We are supposed to choose a 1% progress goal. "If you get one percent better each day for one year, you'll end up 37 times better by the time you're done".This may relate to James Clear's "Atomic Habits", which is quoted on the same page. I wil try to walk round the block for 15 minutes after my evening meal, but don't know if this is 1%.

Later we were sent a PDF recipe book. On looking at this, it is clearly based on the "Eatwell Guide", i.e. nearly 40% of what everyone eats, whether prediabetic or not, should be wholegrain carbs. I can't help feeling that for prediabetes the starch carb recommendation should be lower and that the difference between white rice and brown is not all it is made out to be.

The trainer had used the term "healthy plate" and I asked her if she meant the Eatwell Plate, and she did.

The recipes in the PDF file sometimes say they contain a lot of protein, but e.g. 2 eggs for breakfast do contain protein, but is it enough? Under every recipe there are figures for calories, fat, saturates, sugars and salt. No figures for protein or fibre. I presume saturates is a subcategory of fat.

I'm really very impressed by the Freshwell low carb plan.

 

[Zeppx]

I noticed that the provider of this face-to-face prediabetes programme is Thrive Tribe. Here is a link, relating to gestational diabetes, but it's the same general setup:

NHS England » NHS Diabetes Prevention Programme Gestational Diabetes Mellitus (GDM) provider: Thrive Tribe

Thrive Tribe Get support to reduce your risk of type 2 diabetes today. Find out more and sign up to our 9-month programme through: Our website: healthieryou.org.uk/understanding-gestational-diabetes/ Email: [email protected] Call: 0333 047 9999 (phonelines are open 9.00am – 5.00pm Monday...

www.england.nhs.uk