Diet Dilemmas.

[Zilsniggy]

Hi all,
is anyone else struggling with conflicting advice regarding diet?
As a T2D I also have slightly raised cholesterol.
I have made my diet as cholesterol friendly as I can, but I thought I would also try some Benecol type products with the added plant stencils.
Unfortunately the only ones I have found have synthetic sweeteners which recent research says is no better for “us” than normal sugar, and is probably worse.(micro biome, etc).
I eat berries, etc, but worry about the fructose. Does the
benefit of the phytonutrients, polyphenols, fibre, etc, outweigh the downside of the fructose?
Does the generally accepted benefit of porridge oats helping to lower cholesterol outweigh the fact that it is a carbohydrate?
Has anyone been doing the HFLC diet for long enough to know that it has no long term implications?
I don’t like drinking water, but am now concerned about the aspartame in every single “low sugar “ squash I can find.
It a blooming minefield!

Many people are very confused by this. It is now generally accepted that dietary cholesterol has a minimal effect on blood scolesterol, and that the more important factors are the HDL/LDL ratio, and ttriglycerides. I wouldn’t bother wasting money on anything which claims to have ‘plant stenols’ such as Benecol, since these actually have a minimal effect on cholesterol……don’t believe the hype, they’re just trying to fleece you of your money!
Stay away from porridge, its far too high in carbs, which, although digest slower, still result in glucose being dumped into your bloodstream, just a bit later than the usual 2-3 hour mark..
As for berries and fructose, a portion of strawberries, raspberries etc isn’t going to massively raise your glucose, as the amount of fructose is fairly limited.
HFLC has no long term implications that I’ve heard of, and surely if it does, they can be no worse than the long term implications of uncontrolled diabetes?

 

[JSBr]

Hi all,
is anyone else struggling with conflicting advice regarding diet?
As a T2D I also have slightly raised cholesterol.
I have made my diet as cholesterol friendly as I can, but I thought I would also try some Benecol type products with the added plant stencils.
Unfortunately the only ones I have found have synthetic sweeteners which recent research says is no better for “us” than normal sugar, and is probably worse.(micro biome, etc).
I eat berries, etc, but worry about the fructose. Does the
benefit of the phytonutrients, polyphenols, fibre, etc, outweigh the downside of the fructose?
Does the generally accepted benefit of porridge oats helping to lower cholesterol outweigh the fact that it is a carbohydrate?
Has anyone been doing the HFLC diet for long enough to know that it has no long term implications?
I don’t like drinking water, but am now concerned about the aspartame in every single “low sugar “ squash I can find.
It a blooming minefield!

Haha. This is a subject close to my heart. 2 years ago my total cholesterol levels were a bit high but a good ratio of HDL/LDL so I didn’t change much as I didn’t eat a lot of saturated fat (standard advice was plenty veg, fruit, whole grain, low fat, etc)
Then I got colon cancer, had a section removed and got a temporary ileostomy. The list of advised foods for at least the first six weeks would be enough to make a conscientious diabetic break out in a cold sweat . I wasn’t diabetic.
I.e. white bread, white pasta, potatoes without skin, no veg or fruit, but jelly babies and marshmallows are good, custard cream biscuits but not digestives and so on…)
Then the chemotherapy and steroids sent my HbA1c high so got added to the T2 list and got Metformin. I didn’t get any dietary advice at all from any of the medical people I spoke to about diabetes, but I did cut back on the few things that remained tasting nice while on chemo (ginger sweets, ginger beer)
I now have a large gallstone, so advice for that is to reduce fat intake.
If I eliminate all the things that each condition recommends, then I’m left with lean meat, but I’m not a very enthusiastic carnivore.
I recently spoke with a medical practitioner about all the conflicting advice and she eventually suggested the priority should be to follow the advice for diabetes. Only when I hung up the phone, I remembered I hadn’t had any advice on controlling diabetes.
But I suppose it’s all available on sites like this one.

 

[Nicksellick]

I'm also T2DM. Below T2 HbA1c for eight years now. Diet controlled.

Firstly, don't worry about cholesterol. It protects you rather than harms you. Your body produces cholesterol but it can't be transferred from food.
And I will never take statins but that's just my opinion.
Porridge is very high in carbs, ie glucose. I would avoid it.
I eat some berries... strawberries and blueberries. I don't eat other stuff from nature's candy store ie fruit.
For drinking water, I take San Pellegrino sparkling water. Probably not ideal but nicer than some others.
Hope this helps.
Main thing is, don't worry too much. Keep carbs as low as you can but don't forget to enjoy life.

I love that advice. Thank you.

 

[Nicksellick]

Thanks to everyone. Really interesting.

 

[KitSileya]

I now have a large gallstone, so advice for that is to reduce fat intake.

From what I’ve read, a common cause of gallstones is when the gallbladder doesn’t contract regularly enough to shift the bile kept there. The gallbladder releases bile when you eat something fatty. A low-fat diet may then in fact be a cause of gallstones, which does make me consider the «fat, female, and over forty» bromide about which demographic is overrepresented for cholecystectomies. Perhaps it is diet culture, heavy on carbs and low on fat, that causes it, rather than age, gender and body mass.

 

[Annb]

I had a fairly average diet, not very high in fat but no deliberately avoiding it (female in my 30's at the time and a bit overweight, but not too much) and had a huge gallstone removed. No advice was given about fats at the time but some years later a doctor did say that I could not cope with fats because I didn't have a gall bladder any more. My son had problems for years and eventually also had his gall bladder removed. He never did like fats though (neither animal fats nor vegetable oils). His diet is fairly high in carbs, as was mine all those years ago. I don't think, on the basis of our experience, that fats have very much to do with gall bladder problems. I do think that carbs have quite a lot to do with it though.

 

[Antje77]

No advice was given about fats at the time but some years later a doctor did say that I could not cope with fats because I didn't have a gall bladder any more.

Thankfully they've gone back from that advice since your 30's
After having your gall bladder removed, the advice now is to go a bit careful with the fats at first, and build them up slowly if you find you have issues with them. After that, or if you don't have issues from the start, eat whatever you like, no dietary restrictments for those without a gall bladder.

I now have a large gallstone, so advice for that is to reduce fat intake.

As far as I understand, fatty foods can cause a gall bladder attack if you have a stone already. Personally, I never noticed any pattern in what caused the attacks.
If the stone is bothering you, have they considered taking it out? Or is this a problem with the other medical issues you're facing?

 

[ajbod]

The Gallbladder is simply a reservoir for Bile, produced by the liver. By slowly increasing. your intake of fats, the liver will increase it'd production of bile. Like reducing our fasting sugar levels, it needs to learn how much to raise it's bile output.

 

[CatsFive]

My gall bladder was removed quite a few years ago (well before T2 came along), since then I find if I cut down on fats I get constipated. Apart from a few attacks of biliary colic (one in a hotel room in Dudley!) I had no symptoms until the day it burst. And I've not had digestive problems since apart from constipation.

 

[JSBr]

Thankfully they've gone back from that advice since your 30's
After having your gall bladder removed, the advice now is to go a bit careful with the fats at first, and build them up slowly if you find you have issues with them. After that, or if you don't have issues from the start, eat whatever you like, no dietary restrictments for those without a gall bladder.

As far as I understand, fatty foods can cause a gall bladder attack if you have a stone already. Personally, I never noticed any pattern in what caused the attacks.
If the stone is bothering you, have they considered taking it out? Or is this a problem with the other medical issues you're facing?

I haven’t really had a problem with it. It was found during a scan of my liver when I had raised enzyme levels after chemo. They don’t treat gallstones unless they’re causing problems. Then it’s removal of the gallbladder.

 

[Annb]

I haven’t really had a problem with it. It was found during a scan of my liver when I had raised enzyme levels after chemo. They don’t treat gallstones unless they’re causing problems. Then it’s removal of the gallbladder.

I was told that removal of the gall bladder was the last resort but the preferred option was to remove or break up the stone/s. Total removal was the case for both myself and Alistair because the stones were so big that they were impossible to remove any other way. They even gave me mine to demonstrate just how big it was! Tom kept it in a jar which I only found recently and dumped. Nothing particularly morbid about it, but couldn't see the point of keeping it.

 

[Sunnysky]

HFLC has no long term implications that I’ve heard of, and surely if it does, they can be no worse than the long term implications of uncontrolled diabetes?

Or the side effects of the drugs used to control diabetes and related high blood pressure, cholesterol etc

 

[AloeSvea]

Personally, I look at current official dietary guidelines (as in High Carbs Low Fat) much like bloodletting was back in the day.

Medical professionals of the time genuinely believed that taking blood from sick people was really going to help. Of course, sometimes it hastened death, and always weakened the patient. But it was the official medical line.

Bloodletting - Wikipedia

en.wikipedia.org

What is bloodletting, and why was it a popular therapy?

In this Curiosities of Medical History feature, we look at bloodletting, the historical practice of withdrawing blood for the improvement of health.

www.medicalnewstoday.com

The medical news today article is oddly, imho, quite positive!

I think it always pays to use logic, for any treatment, and engineering principles for body systems, and don't trust official lines and medical professionals and professional nutritionists unless a treatment passes the logic test. Medical professionals can be truly magnificent, but they are not gods and goddesses.

I say this as I trusted my governments, and I trusted the tenants of modern nutrition, until my metabolic diseases glared at me and asked me to delve into the rationale behind official dietary guidenlines.

Yes - thinking about the role of bloodletting back in the day helps give it a bit of perspective.

 

[Firefly1]

I'm not sure anyone really knows the answwers to your questions in terms of you as an individual. Some people will claim to do so in terms of large populations, but they also get things wrong, see the "eatwell plare" as an example.

My blood lipids are much better then they were four years ago despite not eating anything that follows the official advice. My cholesterol has come down (nb I don't think this is at all important, but the health service obsesses about it). The Hunt2 study on cholesterol and mortality found no association with mortality (and a positive association of high cholesterol with longer life for women)

https://pubmed.ncbi.nlm.nih.gov/21951982/

using the same data, the BMJ also criticised the standard Euro and UK guidelines for over-identifying risk.

Estimating the high risk group for cardiovascular disease in the Norwegian HUNT 2 population according to the 2003 European guidelines: modelling study

Objective To estimate the high risk group for cardiovascular disease in a well defined Norwegian population according to European guidelines and the systematic coronary risk evaluation system. Design Modelling study. Setting Nord-Tröndelag health study 1995-7 (HUNT 2), Norway. Participants...

www.bmj.com

As I had a good number of painful and likely to get worse diabetic symptoms, even if i believed I was marginally increasing my heart disease risk (which I don't), keeping my blood glucose in normal range would be my priority.

I found Dr Malcolm Kendrick's book "The Clot Thickens" to be a good read on this subject.

Whole heartedly agree. Lowering the complication symptoms and risk was a key decision factor for me.

 

[Firefly1]

Here in the US, the Standard American Diet (SAD)… needs an overhaul.

 

[Omar51]

Personally, I look at current official dietary guidelines (as in High Carbs Low Fat) much like bloodletting was back in the day.

Medical professionals of the time genuinely believed that taking blood from sick people was really going to help. Of course, sometimes it hastened death, and always weakened the patient. But it was the official medical line.

Bloodletting - Wikipedia

en.wikipedia.org

What is bloodletting, and why was it a popular therapy?

In this Curiosities of Medical History feature, we look at bloodletting, the historical practice of withdrawing blood for the improvement of health.

www.medicalnewstoday.com

The medical news today article is oddly, imho, quite positive!

I think it always pays to use logic, for any treatment, and engineering principles for body systems, and don't trust official lines and medical professionals and professional nutritionists unless a treatment passes the logic test. Medical professionals can be truly magnificent, but they are not gods and goddesses.

I say this as I trusted my governments, and I trusted the tenants of modern nutrition, until my metabolic diseases glared at me and asked me to delve into the rationale behind official dietary guidenlines.

Yes - thinking about the role of bloodletting back in the day helps give it a bit of perspective.

This seems like an excellent article to read, obviously not sure how to implement.
I make it simple for myself, I record everything and strictly follow my blood glucose test meter. I keep my FBG under 5.5 mmol. All my test results are in the non diabetic range. I am pre diabetic over 14 years and don’t take any medicine, life is good

-Omar

 

[AloeSvea]

Hi @Omar51 - it would be a hoot if we turned up at our medical practices requesting bloodletting for our T2D . Along with the advice to eat lots of wholegrains, eat porridge, and sugar is OK in moderation along with a balanced diet etc etc - it would be very hard to keep a straight face.

 

[Paul_]

Hi @Omar51 - it would be a hoot if we turned up at our medical practices requesting bloodletting for our T2D . Along with the advice to eat lots of wholegrains, eat porridge, and sugar is OK in moderation along with a balanced diet etc etc - it would be very hard to keep a straight face.

I have a nurse appointment on Tuesday next week. I've added this to my mental list of sarcastic responses I keep at the forefront of my mind, to use when they mention the Eat Well plate.

 

[CatsFive]

It's easy to decry Eatwell, but there are huge numbers of people in the UK who don't even eat that well, for a variety of reasons including not being able to afford to do so. If the majority were eating Eatwell, there would be quite a bit less of obesity, T2 diabetes, heart disease, strokes, many cancers.

I wanted frozen okra. It wasn't in my local Asda, Sainsburys or Morrisons. I found it in Icelan where the frozen non-potato veggies were tucked away in a small corner.

Finding it was very depressing. I walked past row after row of UPF, mostly with far more carbs than Eatwell would have. But that's what has made food cheap compared to the 60s & 70s.

I grew up in a house with a decent size garden where we had plenty of room to play, and where my father grew a lot of our summer food. Then we got a chest freezer and were eating home-frozen runner beans all winter as well. Yuck - we had the last of the frozen one day and the first of the fresh the next, which was chalk & cheese. UPFs were a novelty back then.

Cooking is no longer taught. Quite a few people at the bottom end are living in properties where cooking would be very difficult. Quite a few people are working so many hours that cooking is a chore they don't want to do when they eventually get home. I see plenty of expensive kitchens on the media clearly designed by people who never cook. The worst I think was a hob in an old kitchen breast, with a wall each side so no room for handles, and you had to lift a pan around the wall to put it on a worktop. Also kitchens with almost no drawers, and/or drawers no-where near the 'working triangle'.

The rise of the huge American-style fridge is another indication of how much UPF we eat, and maybe of how people are storing food that should be in a larder in a fridge.

 

[Paul_]

It's easy to decry Eatwell, but there are huge numbers of people in the UK who don't even eat that well, for a variety of reasons including not being able to afford to do so. If the majority were eating Eatwell, there would be quite a bit less of obesity, T2 diabetes, heart disease, strokes, many cancers.

I wanted frozen okra. It wasn't in my local Asda, Sainsburys or Morrisons. I found it in Icelan where the frozen non-potato veggies were tucked away in a small corner.

Finding it was very depressing. I walked past row after row of UPF, mostly with far more carbs than Eatwell would have. But that's what has made food cheap compared to the 60s & 70s.

I grew up in a house with a decent size garden where we had plenty of room to play, and where my father grew a lot of our summer food. Then we got a chest freezer and were eating home-frozen runner beans all winter as well. Yuck - we had the last of the frozen one day and the first of the fresh the next, which was chalk & cheese. UPFs were a novelty back then.

Cooking is no longer taught. Quite a few people at the bottom end are living in properties where cooking would be very difficult. Quite a few people are working so many hours that cooking is a chore they don't want to do when they eventually get home. I see plenty of expensive kitchens on the media clearly designed by people who never cook. The worst I think was a hob in an old kitchen breast, with a wall each side so no room for handles, and you had to lift a pan around the wall to put it on a worktop. Also kitchens with almost no drawers, and/or drawers no-where near the 'working triangle'.

The rise of the huge American-style fridge is another indication of how much UPF we eat, and maybe of how people are storing food that should be in a larder in a fridge.

All perfectly valid points, I agree with many that you've outlined, particularly the home economics/cooking angle ("teach someone to fish" and all that). However:

1) Eatwell plate was devised in 2012. This was updated to the Eatwell Guide in 2016. In 11 years, obesity has continued to rise, as have all metabolic syndrome conditions. Maybe it's time to review and acknowledge it's not working?

2) The problem with saying that 50% of the plate needs to be carbs is that for many this will mean processed potato. This is due to many factors, including cost, poverty, not knowing better, or just not having the time.

3) As many of the "charities" and organisations involved in pushing healthy eating are funded by the food industry, many of whom have the sugar industry not far behind them, it's not difficult to see why these initiatives fail. A cynical person might think they're intentionally awful campaigns.

4) Maybe if the NHS didn't serve up such unhealthy slop in their hospitals, people might take them a little more seriously on nutritional guidance.

5) Recommending diabetics consume 150g or more of carbs per day, particularly at initial diagnosis when reducing blood sugars is critical, is so barking mad and negligent that it's inexcusable. There's no nuance to the advice, it's just pushed by the NHS with an attitude of "look up this picture of a plate on the internet and follow it, there's a good little stupid, fat peasant". I cannot adequately sum up my anger and rage in words when it comes to this advice, and I doubt it would be constructive for me to attempt to do so. It needs to change, it's doing more harm than good.