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Dec 2014 update: New research on the Low Carb Diet in general practice


I have found that going on low carb (<100 g per day) has slowly lowered my fasting blood glucose to around 5.4 mmol/L, then last week I was on vacation and my carb intake increased to 150 to 200 g per day and my fasting blood glucose went up to around 6.4 mmol/L. Now, back home and carbs below 100 g and my fasting blood glucose is close to what it was before the vacation. For me, lower carbs equals lower fasting blood glucose.
 
@Southport GP, You don't appear to use the words "high Fat" in your documentation.
I know what you mean when you described diets higher in fats which reads well.
Do you think many people might miss understand that "high fat" means eat as much fat as you want instead of moderately.
 
A valid point but we found that in the context of most of the patients were trying to loose weight this didn't seem to be a problem ,also fat on its own without carbs would seem to be less appetising
 
As its part of research and also very interesting and motivating for folk to know how they are doing most of the participants have their HbA1c, chol including the ratio and liver function done about every 12 weeks
Around last Christmas several of the participants did suffer 'carb creep' and their HbAic went up with their weight after only 4-6 weeks. So they felt a post Christmas test was a usefull wake up call !
 
That is really interesting that you found that their HbA1c went up where my HbA1c has actually gone down as I have introduced some carbs. Does this mean I went past "Prof Taylor's fat threshold" and your participants didn't? Does losing weight through a starvation diet reduce fat in a different way to LCHF as @douglas99 is finding in his thread? Does starvation switch cells into repair mode and not replace as is the theory behind the 5-2 diet and as such repaired my beta cells? May be a combination of them all! Food for thought I think
 
It would, but he tends to be infrequent on his posts unfortunately. I'd like to know it there were ratios as well.

Yes we did the cholesterol ratios on a regular basis and there were significant improvements in the first group of patients - and about fifty more since then -despite a diet higher in fat
 
Yes we did the cholesterol ratios on a regular basis and there were significant improvements in the first group of patients - and about fifty more since then -despite a diet higher in fat


I note you state "cholesterol ratios". Did you observe some patients where their total cholesterol score increased but their ratios were actually very good? If so, what was your approach for those patients, regarding statin recommendations?

I am currently about to go into Round 3 of discussions regarding statins, as my total is high, but trigs and other ratios are good. My GP ended the last conversation (having "allowed" me 3 months to work on my diet) by saying all diabetics should be taking statins. As only my diagnostic tests have ever been in the diabetic range I was hoping for a some form of discounting (as opposed to disregarding) based on that history.
 

That is an interesting point.
@Southport GP
Did you run any similar test to the results from the Newcastle diet, and test your patients glucose tolerance, or reaction to carbs, after a suitable re-introduction period?
Or was it a diet targeted at those who intended to adopt the diet for life, continuing after their weight loss?

Which actually leads to another thought, how do you stop their weight loss, as some on here find that to be an issue?
 

I guess I'd like to know the average length of diagnosis for these patients ( obviously there's bit of margin as we've all had it longer than that )compared to those on the Newcastle trial. I seem to recall Taylor's Banting lecture talking about uninhibiting beta cells which is neither repair nor replacement. Also what percentage of weight lost are we talking about in these trials? Taylor is looking at minimum 15% and the chap he gave as an example in his recent talk had gone down to 74 kg from some enormous figure so if you've just lost just enough weight, I can understand how carb creep could have this effect, especially when combined with a post christmas weight gain.
 

Heavens we are getting to complex stuff now - I find myself on less certain ground
Most of the folk with type two diabetes I have talked to expect that going low carb is a lifelong lifestyle choice and that when they get down to their target weight they may have more fat to avoid further weight loss(and perhaps the odd carby special occasion ) I have several patients who have kept their weight stable for years in this way
The average weight loss on the study was less than Prof Taylor's 15% more like 10% but I know which diet I would prefer to be on (I have been on a low carb diet for nearly two years now)
I have heard it discussed that the longer one is diabetic the less reversible are the metabolic changes and seen some limited evidence for this
 
@Southport GP

Where the patients in your study long term diabetics already low carbing, or recently diagnosed who switched from their old diet to a low carb diet?
Or a mix of both?
 

Thanks for that. Yes Taylor's team looked at reversal in longer diagnosed as initial research candidates were all less than five years post diagnosis and found that best results were around that time frame. It would be interesting to see whether it is just the magical figure of 15% or more weight loss that can trigger reversal by whatever dietary means or whether there is something unique to VLC diets that has this effect in some people.For both groups weight gain whether through carb creep or general additional calories is going to push HbA1c levels up, I'd assume, though those with less visceral fat are going to be able to handle higher carb levels. The chap from US in Taylor's recent slides was 4.2 after a blueberry muffin!
 
Yes the 15% ties up with my data


This graph plots my percentage weight loss against my fasting reading. A 0% weight loss I had a fasting of 9.4 but didnt start testing until February so did not get to see my changes. Within 5 weeks (including the Christmas and New Year period) I brought my levels down to normal at about 12% weight loss (was also on met until end Jan) and at 15% my numbers just tightened up to my current range of 4.8 to 5.2
 
They were mainly newly diagnosed - though since then we have been working with far more longer term diabetics If I get a chance will have to see if the groups vary but suspect the results are very similar
 
They were mainly newly diagnosed - though since then we have been working with far more longer term diabetics If I get a chance will have to see if the groups vary but suspect the results are very similar

So mostly newly diagnosed, on the diet for about a year, average weight loss 8.6kg by March if I'm reading your paper correctly.
Are they still losing weight, or did you find a means to stabilise it? Or did the loss simply stop?
 
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