Balanced Meals

I think you would be hard put to find many people on this forum who agree with the balanced meal ethos put out by the NHS. I view it as vague advice suitable for the healthy. I have never found any advice on this subject from the NHS aimed at diabetics. My own nurse confessed to me that she wished she could stop dietitians from giving such advice to diabetics.

The NHS gave me two diet sheets, one written by the British Hypertension Society and one "To lower cholesterol". Nothing for diabetics.

I am not at liberty to advise you to disregard what your NHS HCP's say but if you felt healthier, happier and were losing weight that you wished to lose on your own diet then it's a no brainer as far as I am concerned.

I totally agree with above, I had BMI of around 35/37 5 months ago before being diagnosed T2, I used the NHS guidelines only as a guideline, and decided to go low carb instead with some experiments in between. I've ditched all starchy carbs and my DN is very happy with my results, weightloss 4 stone, HB thingy down to 30. This works for me.

If your happy with the weightloss and the diet you were on, go back on it, your having some great results, I would suggest to test before and after food to see what food does to your BS, I'm not a doctor or very experienced however this works for me.

On a slightly different point, I recently had an operation 2 weeks ago, I took some advice from this forum about keeping my BS under control after the op and funny enough the advice from the hospital was to eat more protein and cut out the starchy carbs whilst in recovery!!!

Hope this helps in some way. Best of luck

Andy


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The UK plate was never intended to represent what you had on your plate for each meal in any case (it was originally aimed at balance over the day/week)

I'm not a low carber by any means but I don't think that your meals as they are sound unbalanced. I'm a T1 but I have been to 'educational' sessions here in France with T2s so I know what is taught.
.Here in France, and certainly now in the US they often suggest using a version of what is either called the Idaho or Swedish diabetes plate. This isn't low carb by any means but it is certainly lower than you seem to being taught and is well balanced.

It is based on a 9inch plate (so portion sizes are not large) but size can be bigger for people who need more with proportions being similar.
It says '
'The Healthy Diabetes Plate recommends eating three servings from the starch group each day—one serving at each meal. This serving will cover a quarter of your 9-inch plate, no more than 1/2 inch high'
Example of stach portions are 1 slice of bread, 0.5 of a hamburger bun, 0.5 cup of rice, a three inch baked potato.
(100g rice , 100g potato have fewer g carbs than 1/2 a normal sized bagel )

Here is one of your meals that you described using the plate
A you can see the potato on that 9 inch plate is small and could have been replaced with a small piece of bread a spoonful of rice, lentils or even some peas or a piece of corn on the cob which are all also starches

There are carbs in the meal from the yoghurt , the berries and the other veg also. (it is balanced because it contains sufficient protein and fat, fibre, some dairy, a variety of fruit and veg so important vitamins and minerals are likely to be incorporated)

My own dietitian would have specified a plain yoghurt though rather than that pink one! She would also suggest boiled new potatoes rather than baked, very grainy bread rather than white and brown basmati rice ; all because these are lower on the Glycemic index and the latter 2 contain far more fibre/nutrients. For several meals she suggests that the starch included is a legume (ie lentils/beans) again because these are much lower on the glycemic index.

More on the Idaho plate here: http://www.extension.uidaho.edu/diabete ... index.html
similar info from the American diabetes association with a video.
http://www.diabetes.org/food-and-fitnes ... our-plate/

Dyezeegal said:

One step forward two steps back is how I feel right now. My diet plan was so good that when I showed a week's worth of food diary to the diabetic nurse at my surgery she asked if she could keep it! I was losing kg a week and lost 6kg in total and then I went on first part of education course and the dreaded balanced plate came out. I was eating mostly lean meats, fish especially salmon and mackerel, lots of fruit, veg, salad, eggs, skimmed milk, low or fat free greek yoghurt and drinking, as I always have done - water, tea and decaf coffee from time to time (I love tea and drink all kinds often without my usual splash of skimmed milk). My carbs were porridge for breakfast or a bagel (with scrambled egg and a small round of extra lean bacon) and a small baked potato with my lunch or dinner, or rice or a bagel. The starchy carbs on dinner plate did not equal two thirds of half a plate, as that is too much for me. My heart sank when I was told that I had to pack so many starchy carbs into my diet. Surely we are all different. I am not an athlete or a very active person so surely I should eat LESS carbs than someone who needs so much energy. Have no problem with having SOME starchy carbs with each meal but surely if I have say salmon with veg for lunch, half a bagel will suffice, or two small new potatoes. That is mostly veg, then the salmon and LEAST of all the starchy carbs. Not a balanced meal, am told. Surprised to hear I did not lose any weight this week? I am not surprised and I am no longer feeling good. High carb foods make me feel sluggish and my mood has gone down. Eating diet high in fruit veg, nuts, eggs and fish and white meats made me feel on top of the world AND I was steadily losing weight. I ditched bread as discovered it does not suit me, was on meds for digestive acid which was wheat intolerance as I am OK now I eat plain bagels instead. I am not testing my BG so I do not know if it was OK with regard to diabetes BUT I am very obese with a BMI of just under 40 so surely losing weight takes priority right now? Please advise.


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Well it does sound like you are eating the way it works for you. Your diet sounds very healthy and I have understood that there is no specific diabetes diet as everyone is so diffent as to what food they can tolerate so I would say carry on with what you are doing you are loosing weight so that can only be good so well done

There is no doubt that if you have anything other than 'mild' diabetes then keeping carbs low'ish is the only sensible option. It's carbs that are converted to glucose in the blood. When I went onto insulin earlier this year my DN gave me a leaflet by Roche for carb-counting which shows plates of various foods and how many carbs they each had. As you would expect all the usual suspects were the high carb items. The NHS speaks with forked tongue on the subject of carbs. Some T2s get the 'stuff yourself with carbs' advice yet T1/T1.5s get the 'watchout for carbs and increase the insulin accordingly. One of these pieces of advice is wrong and guess which it is. I think you now know. Good luck with a diet suitable for diabetics.

Hi. Yes the body does burn fat if no carbs are available; it's called Ketosis. This is often confused with Ketoacidosis which is when the body is burning fat (which produces some ketones) AND in the presence of high blood sugar and is dangerous. Ketosis is what happens when athletes hit the 'brick wall' in Marathons and is not considered dangerous. You may have heard that some communities such as the Inuits have a diet almost devoid of carbs and seem to survive quite well. The important thing is to have a broad spread of the essential nutrients. Isn't it amazing that Nutritionists often don't understand basic nutrition....

Daibell said:

Hi. Yes the body does burn fat if no carbs are available; it's called Ketosis. This is often confused with Ketoacidosis which is when the body is burning fat (which produces some ketones) AND in the presence of high blood sugar and is dangerous. Ketosis is what happens when athletes hit the 'brick wall' in Marathons and is not considered dangerous. You may have heard that some communities such as the Inuits have a diet almost devoid of carbs and seem to survive quite well. The important thing is to have a broad spread of the essential nutrients. Isn't it amazing that Nutritionists often don't understand basic nutrition....

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They also have one of the shortest lifespans, so maybe not an example I want to follow too closely.

I went to see my dietician today. I took my food record for last week, I'm not eating enough. Been on 1200 calories too long!
So, I have to change my breakfast, and I'm going to try porridge, subject to bs being ok. More fruit at lunch, more salad, maybe a livlife bread open sandwich. More dairy, (skimmed, not full fat), so maybe a yoghurt a day as well, (Muller light).

She is an excellent NHS dietician, balanced meals, so low fat, high in fruit and veg, lean meat, chicken, and fish, little red meat, and very open to the fact I eat only carbs that aren't bad for me. She still prefers a balanced meal to a high fat one, and I can't say I've found anything that makes me think otherwise long term. So I'm also open to her ideas as well.
So tonight quinoa and bulgur wheat added to the liver and veg, with a dry tortilla spice mix. No spike, so they're on the menu for a month until the next review.
The problem with nutrition is it's far from basic, so I'm happy to listen to someone that understands the intricate aspects of it, but can still make it simple enough for me to follow.

People talk about a "balanced diet" as if anyone actually knew what that is. We know much more about rat or dog nutrition than about humans. Much of what healthcare professionals tell us is quotes fom textbooks which have no scientific basis.
I would say. Go back to what you know suits you best. If you are keeping your bg right, losing weight and feeling fit, your diet is balanced for you.. Provided you have a variety of foods, I suspect you'll get all you need. NO-one has ever been able to demonstrate that we need ANY dietary carbohydrate. Don't lt them bully you away from what is right for you. A BMI of near 40 NEEDS to be got down. It's too much for your joints and your respiratory system to handle. Stick to your guns and get fit and well.
Hana

Dyezeegal said:

Today I am having fat free greek yoghurt with fresh fruit for breakfast, a full English with a hashbrown, at a cafe, at around about midday, not fried, grilled, and no toast or anything, just one sausage, one rasher of bacon, scrambled egg, beans and tomato and the small hashbrown and on a very small plate, not one of those super sized all days that cafes tend to offer (this is after a long walk and trip to my gym) and then busy afternoon and for dinner this evening, a plate half full of cauliflower, brocolli, shredded white cabbage (from freezer) and carrots, and a fresh salmon steak baked in the oven in foil with a small amount of olive oil and a sliced lemon packed inside. Am not going to count the calories, no need. My only starchy carb will be my lunchtime waffle. I won't need, or indeed have time to snack as I have busy day lined up but if I DID snack would probably have handgul of nuts or a banana. I vary my foods every day and sometimes do starchy carb ay breakfast as I love porridge or scrambled egg on a bagel. My nurse at doc's surgery loved my diet and my weightloss and I can see that she will be my mentor.


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Sounds exactly like my diet. I agree, no need to count the calories, just a sensible amount of good food.
I tried the porridge (half a bowl) for breakfast today, no bad spike, so that's on the menu for me now.
I will be counting calories until I hit my target weight, by that more portion size rather than actual counting, (I have done it long enough to know what's about right), then I'll simply up the amount I eat, and use the scales every day.

Dyezeegal said:

I was eating mostly lean meats, fish especially salmon and mackerel, lots of fruit, veg, salad, eggs, skimmed milk, low or fat free greek yoghurt and drinking, as I always have done - water, tea and decaf coffee from time to time (I love tea and drink all kinds often without my usual splash of skimmed milk). My carbs were porridge for breakfast or a bagel (with scrambled egg and a small round of extra lean bacon) and a small baked potato with my lunch or dinner, or rice or a bagel.

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With a bit of tuna, maybe some olives, it is positively healthy I would have said, depending on what veggies you eat. Whoever has said this is not balanced is really only focussing on your lack of carbs and fibre. Otherwise it looks very balanced to me, especially for someone who is intent on weight loss, something the complainant seems to have forgotten. You can't have both a full and a balanced diet and still lose weight. When people need to lose weight, they need to do without something so the body is forced to lose fat. Balance doesn't come into it really. What dieticians are normally concerned with are things like essential vitamins, nutrients and fibre.

Personally I'd substitute rye bread for the bagel if you can tolerate rye. That has a lot of indigestible fibre and maybe you could eat more pulses. Again it says they are carby on the packaging but a lot of it is either indigestible or belongs to a group of oligosaccharides which are hard to digest, hence the flatulence that you get with beans.

Basically though you are eating what I ate and I lost 30Kg in six months. I've stuck now and am going to have to rethink if I want to lose more but the food I have been eating is much better than what I used to eat.

Dyezeegal said:

Having been told that carbs push up BG and that the pancreas produces insulin to counter this

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Having just read this, along with my previous comment that the dietician seems to have lost focus that your objective is to lose weight, it also seems that the dietician is not really thinking about your diabetes. As you say, you have some sort of metabolic disorder which interferes with the insulin function, yet the dietician is talking as if everything is in fine working order.

The dietary advice is probably OK for someone with a BMI of less than 25 and for someone who has normal BG levels. But this isn't you. It's one size fits all advice. The dietician is simply repeating knowledge, not applying it to your situation.

Hi#


look for posts bout the Newcastle Diet or Newcastle Study. This is the low cal meal replacement study that you refer to.

Newcastle University also have a section on their website

http://www.ncl.ac.uk/magres/research/di ... versal.htm


Let us know how you get on. I also love th carbs and cals book. What an eye -opener.

Cara