Eat to your meter and Controlled Carb Regimes

[lucylocket61]

I think that 130g is a good starting figure. I worked out that I used to be eating 200g at least every day before learning about carbs and often much more (I love Maltesers)

So it was a good figure to aim for, and it is easier to go down than up. I decreased my carbs by 10-20g a week until I felt comfortable and my meter reading were under 8 after eating. So I have sort of stabilised on around 80g a day now to achieve control.

As long as people understand that 130g is only a starting average figure and they can tailor it down to their own best level for them, whatever that is, I think it is a good, helpful figure. Especially as I am a woman who is 5'3" tall so need fewer carbs anyway.

As a newbie, it helps to have something to work on, both with bs level targets and carb targets.

 

[Defren]

I think that 130g is a good starting figure. I worked out that I used to be eating 200g at least every day before learning about carbs and often much more (I love Maltesers)

So it was a good figure to aim for, and it is easier to go down than up. I decreased my carbs by 10-20g a week until I felt comfortable and my meter reading were under 8 after eating. So I have sort of stabilised on around 80g a day now to achieve control.

As long as people understand that 130g is only a starting average figure and they can tailor it down to their own best level for them, whatever that is, I think it is a good, helpful figure. Especially as I am a woman who is 5'3" tall so need fewer carbs anyway.

As a newbie, it helps to have something to work on, both with bs level targets and carb targets.

As is said here on an almost daily basis, we are all different. 80g of carbs is way, way to high for me. On my absolute maximum high carb day I was exactly half your 80g. Even with 40g my BG rose and was effected the next day. Ultra low carbs works for me. I stay in ketosis and do feel my body works much more efficiently!

 

[lucylocket61]

so do you think the starting figure should be lower - perhaps 100g Defren? not arguing or disagreeing, I'm searching for the right info to give anyone newly diagnose I come across, who may not have web access or before they come here.

 

[xyzzy]

I think that 130g is a good starting figure. ...

Lucy

The issue to me and why I promote this "Swedish diet" is that it may not be what everyone considers to be a perfect starting point in terms of grams per day but it is an alternative diet to the 50% carbs, 33% starchy carbs nonsense that people are told is the correct diet for diabetics in the UK.

Lets remind ourselves of that nonsense shall we. Here are the NHS 2012 guidelines

NHS Diet Advice for Diabetes

In the UK, current 2012 NHS diabetes diet advice is that there is no special diet for people with diabetes.

Many people with diabetes focus on the carbohydrate content of their meals and prefer a low-carb diet for tight blood glucose level control.

The NHS (and Diabetes UK) recommend a healthy, balanced diet that is low in fat, sugar and salt and contain a high level of fresh fruit and vegetables.

NHS dieticians' advice

Earlier this year, top NHS dieticians were reported as providing the following tips for people with diabetes.

Together, these can be said to sum up the NHS approach to controlling type 2 diabetes with diet.

Eat plenty of starchy carbohydrates
Eat carbohydrate foods with a low GI
Avoid high GI foods, especially between meals
Eat regular meals and healthy snacks
Don’t miss breakfast
Don’t skip meals
Avoid all unhealthy/hydrogenated fats
Choose low-fat dairy products
Check food labels
Choose lean meat and remove fat and skin
Avoid fried and fast food, and baked goods
Keep hydrated and avoid binge-drinking


Base meals upon starchy carbohydrate

The NHS advises people, including those with diabetes, to base meals around food with starchy carbohydrate such as:

Potatoes
Cereals
Pasta
Rice
Bread

Now compare it to the Swedish moderately restrict carb diet key phrase that I promote as a start out position.

The diet consists of meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet includes less sugar, bread, cereals, potatoes, root vegetables and rice than a traditional diabetes diet.

So there is definitely a difference and that difference needs to be justified if I am going to promote it in my new members posts. The point is if you or I want to seriously change peoples attitudes against that HCLF prevalence then the only way of doing that is to promote a diet that has the credentials to do so. The "Swedish diet" does exactly that. It has the backing of what is considered to be one of the worlds leading health systems. The diet was even taken through the Swedish legal system back in 2006.

The low carb, high fat diet (LCHF diet) has developed a strong following in Scandinavia, having originated in Sweden.

The story goes that Swedish GP Dr Annika Dahlqvist was subject to an investigation after being reported for recommending a low carb, high fat diet to her patients.

The investigation though cleared Dr Dahlqvist of wrong doing based on their findings that her methods were scientifically sound.

What is the low carb, high fat diet?

As the name suggests, the diet suggests eating high fat and low carbohydrate foods.

The LCHF diet is different to such diets as the Atkins diet as there are no ‘stages’ to work through, so the diet can be followed indefinitely.

http://www.diabetes.co.uk/diet/low-carb-high-fat-diet.html

You can read her diet recommendations in English here

http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in

If you read carefully she kind of says what I do. Which is for T2 carbs are the important thing to reduce THEN on the carbs you find you can eat adopt a low GI approach to them. It really does seem pretty obvious non complicated stuff.

So the reason I promote it is very bluntly as a means of replacing the UK dietary recommendations as they will kill you young.

Do I follow my own advice? NO

My current grams / day average since diagnosis is currently 60g thats a lot less than Swedish diet. As I've stated countless times on this forum to me its all about BG's not diets so I eat at 60g to give me very strict BG control as thats what I want. I COULD probably now after losing weight 4 months down the line tolerate around 100g / day and keep below 8.5 but thats not strict enough for me so I restrict lower. That's my informed choice.

Likewise I'm still not entirely convinced about the High Fat bit of LCHF. I try and eat what could best be described as Low Carb, Medium Fat, Medium Protein i.e cut the carbs and up the fats and the protein to compensate for the calorie loss but I do make sure I don't eat the dangerous fats but saying that LCHF rules out dangerous fats as well or at least in the Swedish form.

If as a man with say a BMR requirement of 2500 cals / day but ate 2000 cals / day to lose weight I adopted the Swedish diet I would guess that would end up around eating 150g / day which is far to high for me. That's the reason I take the liberty of then really saying "Go Swedish" but take the American 130g / day recommendation.

I still think that's a valid position to promote to a new person as they have to be pointed in a direction away from "starchy carbs" but still feel confident when they read the new advice that its coming from a reliable and trustworthy source. What better than the country that is perceived to have the best state health system and then enhance that with the recommendation of the worlds most technically advance country. Must be a winner!

Totally agree with you that once someone gets going they can change. They can go "up" and accept more meds or my preference is to persuade them to go down IF they need to. They can go as low as they want as I'm not anti VLC or Newcastle or Diet Only No Meds. Just make sure you gat back to safe levels.

All that's then left is for that new person to decide with all the evidence available what is "safe" which is why I promote what ever diet you prefer so long as its reasonably healthy, and however many grams / day or low GI or however you choose then your diet choice is SECONDARY to what your meter is telling you.

 

[Defren]

so do you think the starting figure should be lower - perhaps 100g Defren? not arguing or disagreeing, I'm searching for the right info to give anyone newly diagnose I come across, who may not have web access or before they come here.

I don't suggest any figure Lucy. I was diagnosed, read this forum and bottomed my carbs. I found for me 20g or less a day keeps me stable(ish). I still do have spikes, but I can manage a <20g diet easily, and I don't feel deprived. It works for me. You must find your own level.

 

[Defren]

xyzzy how can the UK give dietary advice like this:

Eat plenty of starchy carbohydrates
Eat carbohydrate foods with a low GI
Avoid high GI foods, especially between meals
Eat regular meals and healthy snacks
Don’t miss breakfast
Don’t skip meals
Avoid all unhealthy/hydrogenated fats
Choose low-fat dairy products
Check food labels
Choose lean meat and remove fat and skin
Avoid fried and fast food, and baked goods
Keep hydrated and avoid binge-drinking


Base meals upon starchy carbohydrate

The NHS advises people, including those with diabetes, to base meals around food with starchy carbohydrate such as:

Potatoes
Cereals
Pasta
Rice
Bread

And Sweden:

meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet includes less sugar, bread, cereals, potatoes, root vegetables and rice than a traditional diabetes diet.

They are so different. Is there any data on life expectancy for UK and Swedish diabetic patients?

The diet the NHS prescribes is killing people at worst, and leaving them blind, minus limbs, organ failure at best. Why do you suppose that even with the experience of diabetics who choose to modify their carb intake the NHS still carries on with a life expectancy reducing diet? It all seems ludicrous to me. Why not tell diabetics they MUST reduce their carb intake? Sigh!

 

[xyzzy]

Why not tell diabetics they MUST reduce their carb intake? Sigh!

Because, and this maybe shocking news. They don't necessarily all need to!

Think of it this way. Me, you, Lucy, whoever... are T2's with some insulin function left and when we do the (V)Low(er) carb thing and get good results we are doing something new(ish). Something that for example hasn't been taken into account with the mortality / complications stats so imo they are pretty useless as they only tell you the rates of the unlucky T2's who haven't found this new way. I'm not sure if Sweden has published updated data as they did only swap to the new way officiallly in 2011.

But don't forget all the other diabetics out there. For example T1's and insulin dependent T2's can inject to cover carbs so they can quite happily adopt a different type of healthy diet be it low carb based, low GI based or whatever based. The key feature I would say is the broad term "healthy". So to simplify things horribly as an insulin using diabetic you are looking for a healthy diet that keeps you at a nice healthy weight and allows you to get excellent control of your BG's.

Now the T1's and LADA's out there on this forum have their own debates about "healthy" and carbs etc just like we T2's do but to me its a subtly different argument which I wish some would see.

I get angry sometimes when insulin using diabetics tell me what the best diet choice is for people like me who wish to diet control or diet + Metformin only. Why do they think they know what's best for me? I would never presume to tell a T1 what is a good diet in anything but the broadest outlines. If I did I would soon know about it! Sometimes I really do feel I'm being patronised for being T2.

It's that key difference that I feel my Swedish friend Dr Dahlqvist recognised and went through the Swedish courts to prove.

She says as a bog standard T2 you do what we do Defren, you concentrate on the carbs and within that framework you can then go low GI as a healthy option but carbs override GI.

I'll say it again this is a DOCTOR who defended herself through the court system of the worlds leading state health system, won her argument and now that health system adopts her recommendations. Who am I or any other non expert to argue against that. I just followed her advice and now after just 16 weeks have the blood sugar levels of a healthy non diabetic and am 3 stone lighter and very happy.

I am now determined very loudly and for as long as it takes to tell other T2's who find themselves in my position that the Swedish way is an option open to them all.

 

[MaryJ]

I'm loving this thread.

It annoys the hell out of me how studies, results etc of people successfully low carbing and controlling their BG's is not being taken on board.

At least if you are given the info in the first place you can make an informed decision. There will always be people who will deliberately ignore the problem, pretend its not there, that applies to all illnesses I would imagine, until the symptom/side effects become debilitating.

What about the people who do not have internet access or think their HCP's are Gods. They have no choice, but given ALL the information they may wish to take the low carb route.

But why would they worry, diabetes is a progressive illness, isnt it - I guess they would just think the path they are destined to follow from diet to insulin via 6(?) different medicines is the expected path to follow and with any luck something else will get 'em first.

Mary x

 

[borofergie]

Why not tell diabetics they MUST reduce their carb intake? Sigh!

The answer is cognitive dissonance; the NHS adheres to a dogmatic belief in the low-fat diet, which means that they cannot recommend a low-carb diet (which by it's nature is usually high in fat), not matter what the perceived benefits might be.

Dillinger said it best (edited from what I think that this is the single best post that I've read in a year on DCUK):

This is an example of the cognitive dissonance; the NHS believes strongly that people should have a low fat diet; that means you have to eat more carbohydrate and protein. Diabetics in particular have a greater propensity to heart disease and elevated blood pressure to they should in particular eat less fat (to help their hearts) and less protein (to protect their kidneys from high blood pressure) so that means eating carbohydrate. Which should make everything fine.
(snip)
I suppose one reason why blood testing is frowned upon is that it will constantly expose the NHS approach as nonsense, and it's expensive (in the short term), so you can pour oil on the water and safe money by just getting everyone to stop doing it, shut up and eat your high fibre granary bread with low fat spread and the problem will go away. That is until the diabetic you are treating dies, or goes blind, suffers kidney failure or loses a limb or two, but at least no one was rocking the boat...

I stronly recommend that you read the whole thing if you have time:
viewtopic.php?f=25&t=26856&p=248082&hilit=dissonance#p248082

 

[xyzzy]

Dillinger said it best

This is an example of the cognitive dissonance;

I had to look it up...

A general view of cognitive dissonance is when one is biased towards a certain decision even though other factors, such as environmental factors, favour another alternative.

Based on that definition I think the problem is at two levels.

There is an operational level problem which as Dillinger says is down to cognitive dissonance but there is also a strategic level problem where policy makers are knowingly refusing to change their entrenched positions out of self interest, embarrassment and similar things. This happens a lot when "positions" and "theories" are shown to be wrong. In the end the new theory gets to a tipping point where it then rapidly replaces the old theories along with itssupporters. That's generally how most scientific progress occurs.It's really at the heart of what I'm getting at in the final part of my "position statement" about the failing NHS.

Dillinger your posts are great and you should post more often imo.

 

[lucylocket61]

so are people thinking of replacing or changing the post that Daisy1 puts up for newbies, in the light of new evidence?

 

[Defren]

I will remember to add to my posts that I mean T2. I know nothing of T1 apart from they are injecting insulin and so can higher carbs with insulin to cover. I did mean T2 when I asked the question. My error sorry

Why not tell diabetics they MUST reduce their carb intake? Sigh!

Because, and this maybe shocking news. They don't necessarily all need to!

Think of it this way. Me, you, Lucy, whoever... are T2's with some insulin function left and when we do the (V)Low(er) carb thing and get good results we are doing something new(ish). Something that for example hasn't been taken into account with the mortality / complications stats so imo they are pretty useless as they only tell you the rates of the unlucky T2's who haven't found this new way. I'm not sure if Sweden has published updated data as they did only swap to the new way officiallly in 2011.

But don't forget all the other diabetics out there. For example T1's and insulin dependent T2's can inject to cover carbs so they can quite happily adopt a different type of healthy diet be it low carb based, low GI based or whatever based. The key feature I would say is the broad term "healthy". So to simplify things horribly as an insulin using diabetic you are looking for a healthy diet that keeps you at a nice healthy weight and allows you to get excellent control of your BG's.

Now the T1's and LADA's out there on this forum have their own debates about "healthy" and carbs etc just like we T2's do but to me its a subtly different argument which I wish some would see.

I get angry sometimes when insulin using diabetics tell me what the best diet choice is for people like me who wish to diet control or diet + Metformin only. Why do they think they know what's best for me? I would never presume to tell a T1 what is a good diet in anything but the broadest outlines. If I did I would soon know about it! Sometimes I really do feel I'm being patronised for being T2.

It's that key difference that I feel my Swedish friend Dr Dahlqvist recognised and went through the Swedish courts to prove.

She says as a bog standard T2 you do what we do Defren, you concentrate on the carbs and within that framework you can then go low GI as a healthy option but carbs override GI.

I'll say it again this is a DOCTOR who defended herself through the court system of the worlds leading state health system, won her argument and now that health system adopts her recommendations. Who am I or any other non expert to argue against that. I just followed her advice and now after just 16 weeks have the blood sugar levels of a healthy non diabetic and am 3 stone lighter and very happy.

I am now determined very loudly and for as long as it takes to tell other T2's who find themselves in my position that the Swedish way is an option open to them all.

 

[Defren]

I read the thread, thank you. I still can't get my head around the fact we are told by the NHS to eat our selves to death. As was pointed out in that thread, any other professional persons would loose their jobs. If I had let people down the way the NHS seems to be letting diabetics down, my career and my clients lives would have been ruined. But the HCP are peddling a diet that could end ours!

Why not tell diabetics they MUST reduce their carb intake? Sigh!

The answer is cognitive dissonance; the NHS adheres to a dogmatic belief in the low-fat diet, which means that they cannot recommend a low-carb diet (which by it's nature is usually high in fat), not matter what the perceived benefits might be.

Dillinger said it best (edited from what I think that this is the single best post that I've read in a year on DCUK):

This is an example of the cognitive dissonance; the NHS believes strongly that people should have a low fat diet; that means you have to eat more carbohydrate and protein. Diabetics in particular have a greater propensity to heart disease and elevated blood pressure to they should in particular eat less fat (to help their hearts) and less protein (to protect their kidneys from high blood pressure) so that means eating carbohydrate. Which should make everything fine.
(snip)
I suppose one reason why blood testing is frowned upon is that it will constantly expose the NHS approach as nonsense, and it's expensive (in the short term), so you can pour oil on the water and safe money by just getting everyone to stop doing it, shut up and eat your high fibre granary bread with low fat spread and the problem will go away. That is until the diabetic you are treating dies, or goes blind, suffers kidney failure or loses a limb or two, but at least no one was rocking the boat...

I stronly recommend that you read the whole thing if you have time:
viewtopic.php?f=25&t=26856&p=248082&hilit=dissonance#p248082

 

[Defren]

I would think that would be up to the administrators of the forum, not posters.

so are people thinking of replacing or changing the post that Daisy1 puts up for newbies, in the light of new evidence?

 

[viviennem]

so are people thinking of replacing or changing the post that Daisy1 puts up for newbies, in the light of new evidence?

There is no need to change Daisy1's post, in my opinion. It's just what it claims to be - a general introduction to the whole subject of diabetes, meters and controlling carbs, aimed at a group of people who on the whole are newly diagnosed, and scared and/or upset in as many different ways as there are individuals!

Once people read that introduction (which was developed a while ago by some very knowledgeable and sincere people and has been changed only a little since first devised), with any luck they are not frightened off but maybe will get the courage to have a look round and find out more for themselves.

Also, those who have had advice from their HCP will, on the whole, have had the NHS dietary advice and have been told not to test. Any introduction to a different way of thinking and behaving needs to be introduced gently. Again, in my opinion! :wink: Flatly contradicting the advice of an HCP is not the way to win a person's trust.

This is a great thread, Xyzzy, and a very interesting and reasoned discussion. Thanks for starting it. :thumbup: :clap:

Viv 8)

 

[lucylocket61]

Thanks. I got confused with this bit:

I still think that's a valid position to promote to a new person as they have to be pointed in a direction away from "starchy carbs" but still feel confident when they read the new advice that its coming from a reliable and trustworthy source.

and I think I misread the 'new advice' bit and thought that Daisy1's advice was not up-to-date and was being replaced with new stuff.

Its been a long day.......

 

[viviennem]

Don't worry, it's a valid question . We need to take a look at things we use as standard, just to make sure they are up-to-date.

Yes - a very long day; and a long yesterday, too! :roll: Time I was in bed :yawn: :yawn:

Viv 8)

 

[Anonymous]

one important thing to remember is that having this condition means figuring out what works and what doesn't.... and with type 2 it's a bit different for everyone in what they can and can't tolerate. I'm type 2 and have been since 1998 (maybe undiagnosed before then)... but I've had to change my management of diabetes a few times already. Now I'm on insulin I have better control than I used to... well that is because my own insulin production is too low... so that makes sense. But you certainly can at least in the few years at the start get good control with just diet and exercise. It's good to have these discussions as helps others think about what they are doing. The best advice I can offer is make sure you get regular checks of your insulin production as a type 2... as sitting there trying to get things to work like you always have may not cut it... I've always been told "it's progressive" and didn't quite believe it... although now I know they weren't joking.

 

[xyzzy]

so are people thinking of replacing or changing the post that Daisy1 puts up for newbies, in the light of new evidence?

I hadn't really thought of it in those terms.

Of course the following has been written with my personal bias, others have equally strong and valid opinions so please don't flame my thread its been good up to now...

I put up my new member stuff for T2's as a means of trying to divert a new member away from any possibility of NHS starchy carb indoctrination that I think will harm them. I do that by trying to present an alternate health systems method that is sound, works and uses research from the 21st century. I think I'm valid in doing that because it is a method that is advocated in another country with an equivalently advanced health care system. In fact its advocated in slightly different forms by a number of countries health systems including now the Americans by the looks of things.

That's is the primary difference I see today in 2012. Even three years ago the "Swedish diet" as I call it was in many ways no different from advocating a VLC diet. At that point no healthcare system overtly recommended either. Consequently although everyone back then really knew it worked you still couldn't give it the same weight as "UK Diet" in any official sense.

For the "Swedish Diet" that has now changed and it and a number of other diets now have equal weighting to the "UK Diet" and can be used "officially" in a global context in my opinion.

VLC may well get that status in the next year or two as and when long term study data is analysed and opinions formed but at the moment it doesn't and therefore does not have the official state recommended status even though the Swedes get pretty close to giving it that status.

I have to admit as much as I hate it that the NHS view has the same legitimate right to be advocated because as of yet I and others haven't persuaded the NHS to see the light but as of last year it only has the same legitimacy as the one I advocate no more and no less in todays global world.

Turning to Daisy post I think it does a very good job in trying NOT to advocate the NHS line especially for T2's and for that it should be commended. If I were to recommend change it would be to the "feeling" it gives off.

At the moment in the low carbohydrate sections to me it comes across as "We know the NHS says this but try this instead..." If I were to suggest change it would be to get it more positive and get it to boldly state "try any one of these options that does work instead of the NHS" i.e more confident about promoting dietary advice that is known to work for T2's.

The bigger prize is of course to get the surrounding site to do the same. Give some of those diets it lists equal status as the NHS one and importantly emphasise their equal status to the NHS one.

How much pressure would then be put on DUK the charity if this site and its forum globalised and started to give equal status footing to other diets...

 

[Unbeliever]

Probably someone has noticed and remarked on this before but I dont often look at the DUK site and happened to do so last night.

I noticed that their dietary advice was due to be reviewed in February The previous update was 200. Presumabley they are sill working on the onclusions etc or havent yet updated the site. I wonder if we can expect any changes?