Confusion over carbs

[millicent2014]

There are lots of references on this site to cutting carbs.
Undoubtedly you can have too much of a good thing.
I was referred to a dietician and took with me an honest and detailed record of what I had eaten and drunk
over a week. The only comment she made was that I had a plain omelette and peas plus fruit for desert
for one dinner. Her criticism was that there were NO carbs.
She said carbs should be a third of the plate.
I am very confused now.
How much is too much and how much is too little?
Since diagnosis when the Hba1c was 7.7 in July it was 6.6 last week
so adding carbs hasn't done any damage and I take no pills.
My GP practice does not recommend blood testing as it only shows the current BG level.
They go by Hba1c testing as more reliable.

 

[mo1905]

There is no answer to how much is too much or too little carbs. Reducing carbs certainly helps to keep BG levels in check but it's a personal thing and you need to find a level that you're not only comfortable with but one you can maintain long term. As for you being advised not to test your own BG levels because it only tells you what is happening now is crazy. That's the best time to test. Instant feedback. How can you tell if you can or cannot tolerate certain foods without testing "now" ? How can you guage how exercise affects your levels ? The HbA1C is fine but it's a 3 month average. Say your average is 8, this could mean you are fluctuating between 4 and 12. ( bit extreme but you get my point ? ). I would ask for a meter, if they refuse and I had the funds, I would buy one myself. A meter is the best tool to understand how diabetes affects you in real time. Good luck ! Mo


Sent from the Diabetes Forum App

 

[LittleGreyCat]

One view often stated on this site is that the NHS standard dietary advice is aimed at non-diabetics and at diabetics who need to lose weight as a priority which takes precedence over long term BG control.

In both cases a 'balanced diet' is probably a good way to eat more healthily in the short term and cut down on total calories.

However there is a growing body of evidence to support the view that for T2 diabetics carbohydrates are not a good thing in the long term.

Sugar (a very simple carbohydrate) is starting to be daemonised in the popular press but there is little linkage so far to the fact that more complex carbohydrates can be quickly broken down into sugars.

Oh, and I would change your dietician.

" The only comment she made was that I had a plain omelette and peas plus fruit for desert
for one dinner. Her criticism was that there were NO carbs."

I would love to find a fruit which has no carbs (which of course include fruit sugars)!

Oh, and if you check a nutrition site you may find that peas have 4% carbohydrate.

Anyway, if you can afford it I would recommend that you buy a meter so that you can check which foods spike you BG - that is the way to develop a diet which suits your body. Everyone is different and some can tolerate more carbohydrates than others. HbA1c is a good long term measure but if you are actively trying to improve your BG control it helps to have guidance more than once every 3/6/12 months.

Summary: NHS staff tend to follow the 'party line'. People on this forum tend to report from personal experience. However treat anything you read with a bit of scepticism because people usually reflect their personal beliefs quite strongly and they don't always agree

Cheers

LGC

 

[Yorksman]

My GP practice does not recommend blood testing as it only shows the current BG level.
They go by Hba1c testing as more reliable.

He means he does and he is not alone but, many disagree. My GP told me that I did not get enough test strips and doubled my prescription. My DN said I didn't need to test at all.

Every year there are papers published such as:

A1C Versus Glucose Testing: A Comparison

He may not want you to test your plasma glucose simply because that means giving you a prescription for test strips and, if he is a 'with profits' GP Practice, it costs him money.

Testing however is extremely useful for working out what foods you can eat and what foods you should avoid and just as important, how much you can eat of a certain type of food before it impacts on your BG level. Testing is a useful tool if used thoughtfully. Most GPs simply assume that you can't interpret the data, will panic and will be making endless appointments.

Your body needs about 220g of glucose per day. It produces it from the carbs you eat. If you eat less than that, your body will create its own glucose from non carbohydrate stores. Slowly you will lose weight and, for most type 2s, this is a good thing as you start to lose it in the liver and pancreas. If you combine it with exercise, which helps improve insulin sensitivity and also helps reduce your blood lipids, it is highly beneficial.

Phrases such as 'a third of your meal should be carbs' are just meaningless soundbites. There is a massive difference between the carbs in chickpeas or lentils and the carbs in treacle sponge and custard. One takes ages to digest and the other goes straight into your bloodstream.

Generally, health practitioners are worried about faddy diets. They worry about people eating too much fat and not getting enough fibre but they don't have the time to explain it all to you. The fat on chicken meat or in fish is very different from that on a cold joint of lamb or mutton for example. Artificially constituted hydrogenated fats are completely different from natural fish oils.

I have 2 red meat, 2 poultry, two fish and one vegetarian days per week. I always aim for low GI but sometimes have medium GI carbs and always try to stay below 120g per day. My favourite carbs are wholewheat noodles, wholewheat pasta, converted brown rice and pumpernickel. I also eat wholegrain rye and whole grain wheat mixed breads but only from trusted sources and only in limited amounts. I also eat lots of chickpeas, various beans and lots of lentils. Although 'carby', they are quite different. The type of carbs in thee only get partially digested.

 

[hanadr]

Milicent
1 Fruit contains carbs and your dietician SHOULD know that. However they all seem to be fixated on the "Eatwell plate" and "Heart Healthy" theories. Neither of these has any valid scientific foundation[and have been discredited]. Ask your dietician to show you the studies which prove you need to eat carbs. I've looked for years and not found them. Since I was a scientist,and I'm good at searching: that leads me to believe that there actually isn't any evidence.
Stick to your guns, your health will benefit. Eal VERY low carb, moderate protein and modestly high fat. Keep portion sizes low and fill up on veggies. You'll not go without any essential nutrients there.
Hana

 

[sanguine]

Millicent

Check out the LCHF page in www.dietdoctor.com for a quick intro. You may also benefit from getting the book 'Carbs and Cals' which has hundreds of photos of food and meals with the amount of carbohydrate, calories etc in each. This is great for planning meals and interpreting your test readings.

I've been doing this for just three weeks and can see the benefits already (see signature below).

But as always, it's up to the individual to set diet parameters which are suitable and which work for them.