The following is
@Southport GP 's diet sheet, as included in his first publication, which he shared with us all,
"Low carbohydrate diet to achieve weight loss and improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general practice "
So what should I eat to control Diabetes or Pre-diabetes?
Reduce starchy carbs a lot (remember they are just concentrated sugar). If possible cut out the ‘White Stuff’ like bread, pasta, rice – though porridge, new potatoes and oat cakes in moderation may be fine. Sugar – cut it out altogether, although it will be in the blueberries, strawberries and raspberries you are allowed to eat freely. Cakes and biscuits are a mixture of sugar and starch that make it almost impossible to avoid food cravings; they just make you hungrier!!
All green veg/salads are fine – eat as much as you can. So that you still eat a good big dinner try substituting veg such as broccoli, courgettes or green beans for your mash, pasta or rice – still covering them with your gravy, bolognese or curry! Tip: try home-made soup – it can be taken to work for lunch and microwaved. Mushrooms, tomatoes, and onions can be included in this.
Fruit is trickier; some have too much sugar in and can set those carb cravings off. All berries are great and can be eaten freely; blueberries, raspberries, strawberries, apples and pears too, but not tropical fruits like bananas, oranges, grapes, mangoes or pineapples.
Proteins such as in meat, eggs, fish – particularly oily fish such as salmon, mackerel or tuna – are fine and can be eaten freely. Plain full fat yoghurt makes a good breakfast with the berries. Processed meats such as bacon, ham, sausages or salami are not as healthy and should only be eaten in moderation.
Fats (yes, fats can be fine in moderation): olive oil is very useful, butter may be tastier than margarine and could be better for you! Coconut oil is great for stir fries. Four essential vitamins A, D, E and K are only found in some fats or oils. Please avoid margarine, corn oil and vegetable oil. Beware ‘low fat’ foods. They often have sugar or sweeteners added to make them palatable. Full fat mayonnaise and pesto are definitely on!!
Cheese: only in moderation – it’s a very calorific mixture of fat, carbs and protein.
Snacks: avoid. But un-salted nuts such as almonds or walnuts are great to stave off hunger. The occasional treat of strong dark chocolate 70% or more in small quantity is allowed.
EATING LOTS OF VEG WITH PROTEIN AND FATS LEAVES YOU PROPERLY FULL in a way that lasts.
Finally, about sweeteners and what to drink – sweeteners have been proven to tease your brain into being even more hungry making weight loss almost impossible – drink tea, coffee, and water or herb teas. I’m afraid alcoholic drinks are full of carbohydrate – for example, beer is almost ‘liquid toast’ hence the beer belly!! Perhaps the odd glass of red wine wouldn’t be too bad if it doesn’t make you get hungry afterwards – or just plain water with a slice of lemon.
Where to get more info?
Abook–‘Escapethediettrap’byDrJohnBriffa(2013).6 Wellresearchedandeasytoread.
Internet – Google ‘about.com low carb diet’ for loads more info and recipes, or look into the closely related PALEO DIET; also Google ‘diabetes.co.uk forum low carb’ for contact, recipes and hints.
BEFORE YOU START get an accurate weight and measure your waist, re-weigh and measure once a week to see how you are doing and ask for help if problems or little progress is being made – GO ON DO IT!!!
Box 1. Advice sheet for patients
This was, of course, advice to known patients, who he would be meeting and holding explanatory sessions with. I wonder if he has updated it as his experience has grown, over recent months? The only thing which didn't entirely ring true for me was the bit about cheese. Some "cheeses" do have all sorts of stuff in them, but the less processed, traditional ones admit to very little, if nothing, in the way of carbs.
Sally
You are of course quite correct Sally about the lack of carbs in most cheese - also thank you for pointing out the sheet is what I use as part of a discussion with patients. My view of fats is changing but care is needed for someone who must work as part of a wider NHS team. The basic idea of the diet is to avoid weighing of food which smacks of diet rather than a way of life. Also I think it more important that folk understand the basis of the diet rather than the details.
Recently I was proud to find that my practice spends £20,000 per year less on drugs for diabetes than an average practice.
Only slightly different diet sheet follows:
So what should I eat to control my diabetes?
The problem with having diabetes is your metabolism can no longer deal with sugar, which becomes almost a poison; its consumption needs cutting back dramatically.
Reduce starchy carbs a lot (remember they are just concentrated sugar). If possible cut out the ‘White Stuff’ like bread, pasta, rice – though porridge, new potatoes and oat cakes in moderation may be fine.
Sugar – cut it out altogether, although it will be in the blueberries, strawberries and raspberries you are allowed to eat. Cakes and biscuits are a mixture of sugar and starch that make it almost impossible to avoid food cravings; they just make you hungrier!!
All green veg/salads are fine – eat as much as you can. So that you still eat a good big dinner try substituting veg such as broccoli, courgettes or green beans for your mash, pasta or rice – still covering them with your gravy, Bolognese or curry! Tip: try home-made soup – it can be taken to work for lunch and microwaved. Mushrooms, tomatoes, and onions can be included in this.
Fruit is trickier; some tropical fruits like bananas, oranges, grapes, mangoes or pineapples have too much sugar in and can set those carb cravings off. Berries are better and can be eaten; blueberries, raspberries, strawberries, apples and pears too.
Proteins such as in meat, eggs (three eggs a day is not too much), fish – particularly oily fish such as salmon, mackerel or tuna –are fine and can be eaten freely. Plain
full fat yoghurt makes a good breakfast with the berries. Processed meats such as bacon, ham, sausages or salami are not as healthy and should only be eaten in moderation.
Fats (yes, fats can be fine in moderation): olive oil is very useful, butter may be tastier than margarine and is probably better for you! Coconut oil is great for stir fries. Four essential vitamins A, D, E and K are only found in some fats or oils. Please avoid margarine, corn oil and vegetable oil. Beware ‘low fat’ foods. They often have sugar or sweeteners added to make them palatable. Full fat mayonnaise and pesto are definitely on!!
Cheese: in moderation – it’s a very calorific mixture of fat, and protein.
Snacks: avoid. But un-salted nuts such as almonds or walnuts are great to stave off hunger. The occasional treat of strong dark chocolate 70% or more in small quantity is allowed.
EATING LOTS OF VEG WITH PROTEIN AND HEALTHY FATS LEAVES YOU PROPERLY FULL IN A WAY THAT LASTS.
Finally, about sweeteners and what to drink – sweeteners have been proven to tease your brain into being even more hungry, making weight loss almost impossible – drink tea, coffee, and water or herb teas. I’m afraid alcoholic drinks are full of carbohydrate – for example, beer is almost ‘liquid toast’ hence the beer belly!! Perhaps the odd glass of red wine wouldn’t be too bad if it doesn’t make you get hungry afterwards – or just plain water with a slice of lemon.