Diabetes & Health Strategy Ideas

[Mbaker]

One difficulty which I picked up from a review of low carb/high fat diet vs low fat diets is low carb/high fat diet can have different definitions: such as <120 g carbs per day vs say, < 40g carbs per day. I stick at present nearer the 100 g carbs /day.
But any banding together to form say, a low carb/high fat coalition, needs to account for possible differences of benefit vs little benefit within those gradations. nbci.nlm.nih.gov/pmc/articles/PMC5959976/
Add to that that I have not seen any factoring in of the difference in gut biome between individuals and groups of individuals on various diets. As basic research of non-diabetic individuals has shown BSL responses to various foods varies greatly depending on gut biome.wis-wander.weisman.ac.il/../life-sciences/blood-sugar-levels-response-foods-are-highly-individual?
I am intolerant to cow's milk protein so whilst I can order a cappuccino with soy, at a Xmas luncheon I have to pick out the cheese and tend to avoid the bread - unless someone has gone to the trouble and expense to use goat's cheese or buffalo mozzarella. And I am a little dismayed at the so-called advantages of vegan diets as one risks developing vitamin B 12 deficiency over time un less the vegan includes a pharmaceutical sources of B12 in is/her diet..
Until the research is clearer and more data is available any coalition of diets for diabetes management may not be on firm enough footing - just my thoughts - as the current research talks about the reported difficulty of staying on low carb/high fat diets for long periods of time and that weight loss by any diet is the common denominator in any successful diet for diabetes.
Please do not shoot the messenger - I am still trying to find clear research results from DDM's low carb high fat program for example, beyond the rhetoric.

Your points are a massive area which highlights both issues in the one size fits all SAD diet and the nuances within lower carb eating. Realistically I think these areas can only be guided like the current status quo which is to do a broad brush e.g. all burger chains do fries, which is a big assumption that the majority of "regular" eaters would have fries. I am pitching at the average Josephine / Jo who is not interested in RCT's, arguments and counter arguments, internet forums, but for whatever reason wishes to eat lower carb, so would like the easiest route to identify menu options with minimal fuss.

Below is my high level attempt to guide using real world places my family and I have eaten at recently. The controls (my thoughts) are that the swaps should be within the currently offered food choices, and that butter or other non vegetable oils should come at a premium. The establishment where necessary can uplift the price of the meal; so for example if a standard meal of steak, mushrooms and mashed potato was changed to steak, mushrooms and butter mashed celeriac, this may justifiably but not deemed like for like profit wise and should be reflected in the price, and or if more work is required to deliver the non-standard dish (however I would put a case that if an item is already on the menu, is there a problem).

My Guidance Thoughts:
Protein
The protein should be cooked in either unsalted butter, olive oil, ghee, lard, etc or by other methods such as baking or grilling that does not involve vegetable oil. No sauces or rubs should contain sugar or grain based thickeners. Sauces and dips that are sugared should either be omitted or on the side.

Fat
No vegetable oils or margarines

Carbs
So to swap out pasta, rice, potatoes, chips

Example 1
Roasted vegetables
Mixed salad (minus dressing)
Asparagus
Tomatoes
Butternut squash
Avocado
Spinach
Brocolli
Boiled egg
(taken from David Lloyd - Colchester menu as an example)

Example 2
Roasted Mediterranean Vegetables
Stuffed Portobello Mushrooms
Braised Red Cabbage
Butternut Squash
Spinach
Curly Kale Tomatoes
French Beans
Provencale Salad
(taken from Old Seige House - Colchester)

This is just a quick brain dump and does not cover possible deserts, but is a start (I know Harvester has an active swaps menu as standard).

I do feel the numbers for low carb / keto should be defined, as relied on trials have in my view occasionally stretched what many of us would not classify as low carb. I think the diet doctor definitions are about right as a guide:

Ketogenic - 0 t0 20 grams or lower (I believe Virta Health are 30)
Moderate Low Carb: 20 to 50 grams
Liberal Low Carb: 50 to 100 grams (I have seen some go up 130)

In terms of food protocol choices I believe almost anything is better than SAD or equivalents, and that in the context of Diabetes, as we get tested at least once a year we can check health markers and make adjustments. I think danger comes in for say a 20 year old who is on a protocol for 5 years and has not had medical tests.

 

[Member496333]

The way I view it, if there were no drugs or exogenous insulin available, the only effective dietary intervention for diabetics that saves lives would be low carbohydrate. In the context of diet, it’s literally about carbohydrate. It’s difficult for me to reconcile the logical basis of any disagreement.

Of course that is not to say that I am suggesting every diabetic should go low carbohydrate, but in my view they would have to without drugs or they’d lose a foot.

 

[Resurgam]

My requests for swaps were always for something they were already serving - such as a side salad rather than potatoes - there has been one occasion where a salad proved to be a tiny garnish added to the plate - unless they simply forgot the side salad and it was a garnish.
I don't think that it is too much to ask when the food is already on the menu and being served to customers. I have never expected anything specially prepared or cooked for me - I don't need that, just some flexibility.

 

[Deleted Account]

The way I view it, if there were no drugs or exogenous insulin available, the only effective dietary intervention for diabetics that saves lives would be low carbohydrate.

I think you are writing from a type 2 perspective.
If there were no exogenous insulin available, a diet may temporarily prolong a short life for people with type 1 diabetes but would not save lives.

 

[Member496333]

I think you are writing from a type 2 perspective.
If there were no exogenous insulin available, a diet may temporarily prolong a short life for people with type 1 diabetes but would not save lives.

Yes you’re right. I am viewing from a type 2 perspective. What I meant was that in either T1 or T2, without the availability of drugs or exogenous insulin, any diabetic who attempted to eat any diet based on carbohydrate wouldn’t live too long. I find it impossible to accept that any dietary strategy for treating diabetes would not be based on low carbohydrate. A diet based on carbohydrate requires more drugs to counter. Type 1 or type 2

 

[Mr_Pot]

Restaurants do not have to cater for people on specific diets, all they have to do is warn customers if food may contain allergens. If they provide gluten free or vegan options it is because they can see that they will increase their profit by including those customers. Low carb is not no carb so is not an exclusion diet and as such is open to lots of interpretations, if you also want to insist on food cooked in animal fats, no artificial sweeteners etc,etc then it is a minefield and restaurants will just opt out. If restaurants notice that more customers are choosing lower carb sides, asking for substitutions, no sauce to be added, they will adjust to make that easier, but I can't see LC that satisfies everyone's definition, being a category on menus any time soon.

 

[kitedoc]

Your points are a massive area which highlights both issues in the one size fits all SAD diet and the nuances within lower carb eating. Realistically I think these areas can only be guided like the current status quo which is to do a broad brush e.g. all burger chains do fries, which is a big assumption that the majority of "regular" eaters would have fries. I am pitching at the average Josephine / Jo who is not interested in RCT's, arguments and counter arguments, internet forums, but for whatever reason wishes to eat lower carb, so would like the easiest route to identify menu options with minimal fuss.

Below is my high level attempt to guide using real world places my family and I have eaten at recently. The controls (my thoughts) are that the swaps should be within the currently offered food choices, and that butter or other non vegetable oils should come at a premium. The establishment where necessary can uplift the price of the meal; so for example if a standard meal of steak, mushrooms and mashed potato was changed to steak, mushrooms and butter mashed celeriac, this may justifiably but not deemed like for like profit wise and should be reflected in the price, and or if more work is required to deliver the non-standard dish (however I would put a case that if an item is already on the menu, is there a problem).

My Guidance Thoughts:
Protein
The protein should be cooked in either unsalted butter, olive oil, ghee, lard, etc or by other methods such as baking or grilling that does not involve vegetable oil. No sauces or rubs should contain sugar or grain based thickeners. Sauces and dips that are sugared should either be omitted or on the side.

Fat
No vegetable oils or margarines

Carbs
So to swap out pasta, rice, potatoes, chips

Example 1
Roasted vegetables
Mixed salad (minus dressing)
Asparagus
Tomatoes
Butternut squash
Avocado
Spinach
Brocolli
Boiled egg
(taken from David Lloyd - Colchester menu as an example)

Example 2
Roasted Mediterranean Vegetables
Stuffed Portobello Mushrooms
Braised Red Cabbage
Butternut Squash
Spinach
Curly Kale Tomatoes
French Beans
Provencale Salad
(taken from Old Seige House - Colchester)

This is just a quick brain dump and does not cover possible deserts, but is a start (I know Harvester has an active swaps menu as standard).

I do feel the numbers for low carb / keto should be defined, as relied on trials have in my view occasionally stretched what many of us would not classify as low carb. I think the diet doctor definitions are about right as a guide:

Ketogenic - 0 t0 20 grams or lower (I believe Virta Health are 30)
Moderate Low Carb: 20 to 50 grams
Liberal Low Carb: 50 to 100 grams (I have seen some go up 130)

In terms of food protocol choices I believe almost anything is better than SAD or equivalents, and that in the context of Diabetes, as we get tested at least once a year we can check health markers and make adjustments. I think danger comes in for say a 20 year old who is on a protocol for 5 years and has not had medical tests.

Thank you @Mbaker. I agree except why remove oils like olive oil? Why only saturated fat?

 

[kitedoc]

The way I view it, if there were no drugs or exogenous insulin available, the only effective dietary intervention for diabetics that saves lives would be low carbohydrate. In the context of diet, it’s literally about carbohydrate. It’s difficult for me to reconcile the logical basis of any disagreement.

Of course that is not to say that I am suggesting every diabetic should go low carbohydrate, but in my view they would have to without drugs or they’d lose a foot.

You cannot just state low carb without including either high protein or high fat. Our diets always contains a mix of all three.

 

[Member496333]

You cannot just state low carb without including either high protein or high fat. Our diets always contains a mix of all three.

Yes indeed, but carbohydrate is by far and away the biggest driver of insulin secretion out of those three. Not many people would become insulin resistant eating fat and or protein. In my opinion at least

 

[Mbaker]

The way I view it, if there were no drugs or exogenous insulin available, the only effective dietary intervention for diabetics that saves lives would be low carbohydrate. In the context of diet, it’s literally about carbohydrate. It’s difficult for me to reconcile the logical basis of any disagreement.

Of course that is not to say that I am suggesting every diabetic should go low carbohydrate, but in my view they would have to without drugs or they’d lose a foot.

You raise an interesting area. Often I read "we are all different" which prefaces an alternative view

Thank you @Mbaker. I agree except why remove oils like olive oil? Why only saturated fat?

Olive and how could I forget coconut oil I would put on the good list.

After reading The Big Fat Surprise, cross referencing many videos, Channel 4's Food unwrapped showed the difference between chips cooked in coconut oil compared to vegetable oils - a chemical test of the oils after cooking showed that coconut oil was excellent, whilst the vegetable oil was full of oxidants. The thought of using vegetable oils makes me feel quite sick, deodorisation, bleaching, I have cross referenced many articles like this one https://www.thankyourbody.com/vegetable-oils/. This short video is a good summary:

There has been a 100 year plus experiment on the public, which has led to trans fat (quietly removed, but what level of damage to woman / mankind before removal), other issues hushed up I can't recall right now, but the latest is esterification, which the general public are not aware of mostly (again another experiment to clean up this garbage, as "they" dare not endorse sat fat to save face). Vegetable oils in my view should be banned with immediate effect, there introduction and ramped up use in almost all processed foods especially biscuits, ice cream, bread etc coincides with the lifestyle diseases that are prevalent; I know this is an association but along with grains and sugar it is a major dietary change which I feel is as bad as sugar.

 

[Mbaker]

Restaurants do not have to cater for people on specific diets, all they have to do is warn customers if food may contain allergens. If they provide gluten free or vegan options it is because they can see that they will increase their profit by including those customers. Low carb is not no carb so is not an exclusion diet and as such is open to lots of interpretations, if you also want to insist on food cooked in animal fats, no artificial sweeteners etc,etc then it is a minefield and restaurants will just opt out. If restaurants notice that more customers are choosing lower carb sides, asking for substitutions, no sauce to be added, they will adjust to make that easier, but I can't see LC that satisfies everyone's definition, being a category on menus any time soon.

I see your points, but surely the areas you raise are already factored in within the context of Vegans and Vegetarians. Some of the WFPB hierarchy do not respect some of the choices V's and VE's make as there can be a lot of junk foods. I think you may be right on my full wish list, but hopefully the swaps under the carbs section could fly as demonstrated by Harvester.

I do ask for all the changes suggested or get grills or poached eggs, I do my best to avoid over used vegetable oil.

 

[bulkbiker]

Thank you @Mbaker. I agree except why remove oils like olive oil? Why only saturated fat?

I think part of the problem as is being shown elsewhere is that olive oil is being diluted with other seed oils (to the extent that some contain less oil from olives than from other stuff). It's surely far easier to say butter or animal fat and exclude all seed oils than to try and exclude most but not all?

 

[kitedoc]

I think part of the problem as is being shown elsewhere is that olive oil is being diluted with other seed oils (to the extent that some contain less oil from olives than from other stuff). It's surely far easier to say butter or animal fat and exclude all seed oils than to try and exclude most but not all?

Thank @bulkbiker. If one can source the pure 'good oil' olive oil then I would not hesitate to use it but yes, it is about time that oil companies were taken to task if they are falsifying content information.

 

[kitedoc]

You raise an interesting area. Often I read "we are all different" which prefaces an alternative view

Olive and how could I forget coconut oil I would put on the good list.

After reading The Big Fat Surprise, cross referencing many videos, Channel 4's Food unwrapped showed the difference between chips cooked in coconut oil compared to vegetable oils - a chemical test of the oils after cooking showed that coconut oil was excellent, whilst the vegetable oil was full of oxidants. The thought of using vegetable oils makes me feel quite sick, deodorisation, bleaching, I have cross referenced many articles like this one https://www.thankyourbody.com/vegetable-oils/. This short video is a good summary:

There has been a 100 year plus experiment on the public, which has led to trans fat (quietly removed, but what level of damage to woman / mankind before removal), other issues hushed up I can't recall right now, but the latest is esterification, which the general public are not aware of mostly (again another experiment to clean up this garbage, as "they" dare not endorse sat fat to save face). Vegetable oils in my view should be banned with immediate effect, there introduction and ramped up use in almost all processed foods especially biscuits, ice cream, bread etc coincides with the lifestyle diseases that are prevalent; I know this is an association but along with grains and sugar it is a major dietary change which I feel is as bad as sugar.

Agree with ban on trans-fats but the issue re some vegetable oils is about the temperature they are used at, if too high produces the 'nasty; compounds. Pure olive oil is less affected by temperature than some of the others.

 

[kitedoc]

Yes indeed, but carbohydrate is by far and away the biggest driver of insulin secretion out of those three. Not many people would become insulin resistant eating fat and or protein. In my opinion at least

If the amount of fat ingested caused weight increase then you betcha their insulin resistance may worsen.

 

[Member496333]

I disagree but in any case type 1 isn’t a problem of hyperinsulinemia, it’s the opposite, so I don’t get your concern. My original point stands - in the absence of drugs or insulin, the only effective dietary-only treatment for diabetes is low carbohydrate

 

[Mbaker]

Agree with ban on trans-fats but the issue re some vegetable oils is about the temperature they are used at, if too high produces the 'nasty; compounds. Pure olive oil is less affected by temperature than some of the others.

I don't have a problem with cold pressed olive oil for shallow frying (with no smoke) or extra virgin olive oil for salads and the like. Rapeseed / Canola, Soy etc I wish would depart the earth forthwith. It is an area of significant personal research, Proctor and Gamble kicked it all off with Crisco, I can remember lard being used by my Mum, but also Mazola, Spry Crisp and Dry and generic vegetable oils, as well as margarines.

This is a typical process the Omega 6 touting vegetable oils go through, I put this into a presentation around a year ago and asked my audience if they were happy to use a product that had to go to these lengths to be presentable. The so called benefit of lowering LDL, I will pass on, as I don't subscribe to the diet heart hypothesis, and believe humans have done well with communicable diseases, but have contributed via these types of products to modern disease.

 

[kitedoc]

I disagree but in any case type 1 isn’t a problem of hyperinsulinemia, it’s the opposite, so I don’t get your concern. My original point stands - in the absence of drugs or insulin, the only effective dietary-only treatment for diabetes is low carbohydrate

Again @Jim Lahey, there is no such thing as a low carb diet of any duration. That is misleading - it is low carb (and that might vary from 20 g to 120 g of carb per day) and high fat/increased protein. You will find that in all research papers of any worth about the diet refer to low carb, high fat.
With T1D, my insulin dose does increase if I gain weight.
In addition to excess weight gain many things can cause insulin resistance in me. e.g. intercurrent illness, some medications, stress, watching exciting movies etc.
The general problem, initially in me was low or no intrinsic insulin and yes, that is always what treatment is aimed at preventing, amongst other things.
But if I take excess insulin by injection I sure can have hyperinsulinaemia and weight gain.

 

[Member496333]

I think you’ll find that the insulin dosing makes you gain weight. But anyway I don’t wish to argue. I’m sure we can agree to disagree

 

[kitedoc]

I don't have a problem with cold pressed olive oil for shallow frying (with no smoke) or extra virgin olive oil for salads and the like. Rapeseed / Canola, Soy etc I wish would depart the earth forthwith. It is an area of significant personal research, Proctor and Gamble kicked it all off with Crisco, I can remember lard being used by my Mum, but also Mazola, Spry Crisp and Dry and generic vegetable oils, as well as margarines.

This is a typical process the Omega 6 touting vegetable oils go through, I put this into a presentation around a year ago and asked my audience if they were happy to use a product that had to go to these lengths to be presentable. The so called benefit of lowering LDL, I will pass on, as I don't subscribe to the diet heart hypothesis, and believe humans have done well with communicable diseases, but have contributed via these types of products to modern disease.

View attachment 29874

Thank you, in some ways I am sure that production of milk by a cow or fat by an animal is more complex but provided nasties like insecticides and artificial hormones and infective agents do not blight the product why would one look elsewhere except of course appropriately treated and not over-treated olive oil.