Diet browsing

[smidge]

I think the hope of those that established the eat well plate is that once a 'standard's Type 2 has lost the weight, they will be able to increase their carbs a little as their insulin resistance will have diminished and their pancreas will still be healthy enough to produce insulin. And for the vast majority of Type 2s I believe this is probably true - but that doesn't mean they can go back to their previous portion size and it doesn't help those who didn't have insulin resistance in the first place.

Smidge

 

[douglas99]

I think the hope of those that established the eat well plate is that once a 'standard's Type 2 has lost the weight, they will be able to increase their carbs a little as their insulin resistance will have diminished and their pancreas will still be healthy enough to produce insulin. And for the vast majority of Type 2s I believe this is probably true - but that doesn't mean they can go back to their previous portion size and it doesn't help those who didn't have insulin resistance in the first place.

Smidge

That's the nhs's problem, no two diabetics are the same.
They have to start somewhere, so I guess it's fair to have a standard approach, level the playing field, prescribe the standard drugs. Some common sense obviously, but that's the one thing the doctor should have.
But all things being equal, if that works for the majority, fine.
If not, the 3 month review is where it moves on, then the 6/12 month review to check the progress.

I've been through the process, it worked well for me, I've worked with them, and they've worked with me, it's been mutual, and certainly I've met a range of professionals at all degrees of training, knowledge, understanding, as I'm sure they meet the same range of patients.

 

[Andy12345]

i wished your experience was standard, your experience of their advice is bewildering but heyho

 

[douglas99]

i wished your experience was standard, your experience of their advice is bewildering but heyho

It's took two years so far, but I have really only had good advice, I think the first dietician I saw a couple of years ago wasn't stunning, but they referred me to another one anyway, so even that wasn't a bad experience. And to be fair, I was still wet behind the ears as it were, so at the time it could well have been me, not them.
I've been invited to play a round of introductory golf courtesy of the nhs soon, as part of their keep fit/exercise problem around here.

 

[tonyS54]

The smaller portion may work for some but what about the skinnies who need to put on weight but keep our BGs down?
CAROL

I'm 6'3 and definitely not a skinny but I can relate to cartys problem re portion sizes, I'm on a maintenance diet of around 2500 cals which using the eatwell plate model would mean 1250 cals from carbs, that's a hefty 320g carbs per day.

 

[smidge]

I'm 6'3 and definitely not a skinny but I can relate to cartys problem re portion sizes, I'm on a maintenance diet of around 2500 cals which using the eatwell plate model would mean 1250 cals from carbs, that's a hefty 320g carbs per day.

And therein lies the problem. This is where the 'high fat' part of low-carb has to come in. No diabetic can realistically eat that many carbs and maintain good BGs (possibly with the exception of those prepared to take very large doses of insulin) so the calories have to come from somewhere. There is only so much protein a human can eat so that leaves fat - the most calorie-dense food type, so small amounts add lots of calories. I believe it is only in this part that the medical profession really has a problem with low-carb - most know it makes complete sense but their dilemma is in recommending increasing the fat content of a meal to diabetics who are already at a 20% greater risk of heart disease.

Personally, I don't know if adding fat to the diet increases risk of heart disease. I do know that high BG causes all kinds of serious complications including heart disease, so I go with mitigating the known risk at the expense of the unknown risk. Simply, I prioritise my BG over everything else. That's my logic for low-carbing - no evangelical beliefs, simply a prioritization of the risk of high BG over all other risks.

Smidge

 

[smidge]

That's the nhs's problem, no two diabetics are the same.
They have to start somewhere, so I guess it's fair to have a standard approach, level the playing field, prescribe the standard drugs. Some common sense obviously, but that's the one thing the doctor should have.
But all things being equal, if that works for the majority, fine.
If not, the 3 month review is where it moves on, then the 6/12 month review to check the progress.

I've been through the process, it worked well for me, I've worked with them, and they've worked with me, it's been mutual, and certainly I've met a range of professionals at all degrees of training, knowledge, understanding, as I'm sure they meet the same range of patients.

Trouble is, that approach nearly killed me - is that just collateral damage? You lose the lives of a few hundred non 'standards' on the way but hey ho that's life? Just one look at me 42 years old, 5 foot tall and less than 7 stone should have had alarm bells ringing for them when I presented with diabetes, but they didn't have enough knowledge, skills, intelligence call it what you will, to see that I was not a typical Type 2 and needed further investigation and a different approach.

Smidge

 

[douglas99]

And therein lies the problem. This is where the 'high fat' part of low-carb has to come in. No diabetic can realistically eat that many carbs and maintain good BGs (possibly with the exception of those prepared to take very large doses of insulin) so the calories have to come from somewhere. There is only so much protein a human can eat so that leaves fat - the most calorie-dense food type, so small amounts add lots of calories. I believe it is only in this part that the medical profession really has a problem with low-carb - most know it makes complete sense but their dilemma is in recommending increasing the fat content of a meal to diabetics who are already at a 20% greater risk of heart disease.

Personally, I don't know if adding fat to the diet increases risk of heart disease. I do know that high BG causes all kinds of serious complications including heart disease, so I go with mitigating the known risk at the expense of the unknown risk. Simply, I prioritise my BG over everything else. That's my logic for low-carbing - no evangelical beliefs, simply a prioritization of the risk of high BG over all other risks.

Smidge

" I don't know if adding fat to the diet increases risk of heart disease. I do know that high BG causes all kinds of serious complications including heart disease"

You would think from the advice from dieticians and gp's. if they don't know, they would seem to agree high fat is un-healthy. You have decided the only thing that matters is your bg over everything thing else.
That's your prerogative.
I would be very unhappy if my doctor decided to ignore any other possible health risk to be honest.
So they suggest a compromise to mitigate other risks, and provide a diet that can be survived with meds.
It's mine and your choice to decide to ignore other risks, and change the diet, along with your use of the meds.

I'm sure the advice will change.
I don't know which way, it'll depend on us really, as in a few decades we'll be providing the results for the life expectancy studies quoted on here

 

[Thommothebear]

I'm inclined from all the reading I've done, to believe that eating too much sat fats while on a medium to high carb diet is probably bad for you, especially if there is a large calorie surplus in the diet. i am also inclined to believe that if the calories are correct for weight loss or maintenance and carbs are reduced a compensatory increase in sat fats will probably not be harmful. i am pretty much convinced sat fats are only a real issue where there is high carb intake too.

i don't think its a coincidence that fast food which is often high in both processed carbs and sat/trans fats with little protein are so often linked to coronary/arterial health issues which are subsequently blamed purely on the sat fats.

The thing is that its pretty easy to find scientific/medical evidence in papers to support whatever it is you want to believe, at the end of the day you make your pick and live (or die) with your decision.


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