food and glucose control

Hi Nin,
I dread to think what NHS trusts would be advising people seeing that the NHS guideline for diabetics is the standard high-carb nonsense.

Dennis said:

Hi Nin,
I dread to think what NHS trusts would be advising people seeing that the NHS guideline for diabetics is the standard high-carb nonsense.

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I don't think it's high-carb. They assume most people will want to eat what they've always eaten. ie, a bowl of cereal and a couple of slices of toast for breakfast, a sandwich for lunch, and a meat, potato and 2 veg for evening meal. Include a couple of biscuits and a pack of crisps for snacks, and you have what most people eat for their daily food.
This ISN'T high carb. It's normal.
It's not nonsense. It's living your life as you always have done, with the added extra that you have to take your own insulin.

Personally, I think these forums should be divided into T1 and T2 information, since the two seem incompatible.

oh, and I'm really sorry Nin I know nothing about classes like this. Have you tried asking your local hospital, or diabetic clinic, or doctor? Or checking the web?

Sweet3x,

All of the dietary advice produced by the NHS and DUK is very much high carb. It has been adopted from the American Heart Association which hypothesised that low fat / high carb diets would be protective against heart disease. Clearly they're not. They're certainly not protective against diabetes, that's for sure. America is a few years ahead of us in the obesity and diabetes race, but we're catching up fast.
This high carb diet isn't normal in a historical context. It's a very recent innovation, and is contemporary with the exponential increase in diabetes and obesity. You say that most people eat this way. Aren't most people in the UK overweight these days? You'll have to look hard to find an overweight low carb dieter, despite the fact that, like me, they often eat more calories.

There's absolutely nothing incompatible with T1 and T2 diets either. Any diet that lowers the load on the pancreas, lowers blood sugar, improves blood lipids and assists weight loss can only be good for everyone, surely?

All the best,

fergus

fergus - do u ever take diet histories from people - I somehow doubt that any the so called experts like taubes etc ever do. the problem is not bread is too much sugar , rubbish crisps etc oh alcohol.
I reckon wine is one of the biggest culpprits. people are eating too much full stop. If i took out the rubbish alot of peoples food intake is not that bad. It is the snacking that is the biggest problem - oh and the fact we are a nation of couch potatoes! when we are talikng carbs i think u really need to make a distinction - there is a huge difference.

Uk dietitians do not use anything remotely rec from the ADA - they seem to just hand out a standard 1800 calories . Your mention of a so called high carb intake is not new actually - look at what people ate years before us and they ate bread, albeit course , potaoes etc but no junk. No one advocates a low fat diet - perhaps u would like to elaborate what u actually mean.

I have told u time and time again the problem with diabetes care is that too many people are giving out info - nurses , doc etc - they do not have any depth of knowledge in nutriton and food.

OH Dear! we seem to have fallen for the myth of the Healthy Balanced Diet don't we and the modern "why can't we do we do as we please? attitude.
We diabetics cannot keep healthy on a high carb diet.( Look at that healthy plate image!) How can we if our carbohydrate metabolism is compromised? How many type 1s would survive for more than a few weeks without insulin and eating carbohydrate? The high levels of glucose in their blood would kill them fast. without help from the ketones! That is the evidence that carbs are bad for us. Who needs more? Type 2s are different in some ways. The decline is probably slower in untreated patients. In fact it's seen as a progressive disease. Bernstein has shown that it needn't be.
How many of us would advise a coeliac to eat as much gluten as he/she pleases and we'll give medicines which relieve the symptoms.
It's not an imposition to tell a diabetic to eat less of the stuff that could kill him. Breakfasat cereal and a couple of slices of toast first thing in the morning is no-one's RIGHT. neither is a sandwich at tea time.
I've just had 2 fried!! rashers of bacon and a fried egg for my breakfast and it was delicious!
Also my BG is under 5 nearly all the time and I've lost 35 pounds and 2 dress sizes since last year. All whilst reducing my use of medication. Taubes helped me. He researched for years and went through a huge body of published material. All of the references are in his book. He's a journalist/writer,Not a scientific researcher ( although some B. Sc.s and PhD s are not very scientific either.)
You can't be a diabetic and have it both ways. If you want to remain healthy, don't eat stuff that harms you and then take masses of dangerous medicines. there is a price to pay for that road. It's probably the high incidence of cardi-vascular disease in diabetics.
NO_ONE has done a real study on the health of those of us who have seen the light, but My diabetes nurse says that her low carb patients are doing particularly well, although it's something we found for ourselves and not a recommendation from her.

Ally,

I don't want to keep going over old ground, but a bit of historical perspective would be good. The genesis of the 'Eat Well Plate' can be traced back to the US 'Dietary Goals for the United States' in 1977. It was this US government funded study which underpinned the infamous 'food pyramid' and all subsequent Western government funded dietary advice since. We have imported it along with our headlong rush into obesity and diabetes.

I agree with you when you say that sugar is the problem, but isn't that an admission that the standard advice from the NHS, to 'base your diet on starchy carbohydrates' supports that problem? Starchy carbs are very quickly metabolised into sugar, are they not? So such a diet, which continually repeats the mantra 'eat less fat' (why do you keep missing that bit!) is inherently higher in sugar and lower in fat. I gave you an example before of a diet on the DUK website which had a ridiculous 12.5% fat and I know from bitter experience that if I were to eat like that for even a few days my weight would increase, I'd need much more insulin, and my blood sugars would be up and down like my 4 year old on a bouncy castle. It's just plain daft.

As you say, the standard dietetic approach seems to be just to hand out a standard 1800 calories, with little recognition that all calories are absolutely NOT equal. There are innumerable clinical studies of dietary restriction trials where intakes as low as 1250 calories per day do not induce successful weight loss or, crucially, normal insulin levels. The so called 'paradoxes' where other trials show much greater success with diets higher in calories, provided those calories come from fat and protein aren't paradoxes at all. They are convincing evidence that obesity and diabetes are, fundamentally, metabolic disorders exaccerbated by the consumption of starches and refined carbohydrates.

I'm sure you do a grand job coaching your patients to ditch the junk and eat proper food, and that's a noble cause. In my darker moments, however, I'd like to see some of the nutritionists who tow the party line have their pancreas switched off for a couple of weeks to see how their ideas actually work out first hand. I think they'd change their minds pretty quickly after that!

All the best,

fergus

!

oh and ps as i was weeding the garden i thought how patronising that comment on coaching was!

hanadr said:

The high levels of glucose in their blood would kill them fast. without help from the ketones! That is the evidence that carbs are bad for us. Who needs more?

I've just had 2 fried!! rashers of bacon and a fried egg for my breakfast and it was delicious!
Also my BG is under 5 nearly all the time and I've lost 35 pounds and 2 dress sizes since last year. All whilst reducing my use of medication.

You can't be a diabetic and have it both ways. If you want to remain healthy, don't eat stuff that harms you and then take masses of dangerous medicines. there is a price to pay for that road. It's probably the high incidence of cardi-vascular disease in diabetics.
NO_ONE has done a real study on the health of those of us who have seen the light, but My diabetes nurse says that her low carb patients are doing particularly well, although it's something we found for ourselves and not a recommendation from her.

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oh for heavens sake. Of course eating carbs without taking insulin would 'kill' a diabetic. That's why we need the insulin. It's not that carbs ar... sorry, starchy carbs .. are 'bad for us'! It's the lack of insulin in the system that is dangerous.

I'm so glad that you enjoyed your fried breakfast. I hope that your arteries are just as happy as you are, in a few years to come. And your waist line. Well done for losing all the weight, however. It must be nice coming closer to a 'healthy' size. Keep up the good work!

Since when has Insulin ever been dangerous?? I think I can safely say that Insulin has not, nor ever will, cause Cardi-Vascular disease in diabetes. That will be strictly down to the fact that the person was hugely overweight, and this is also the cause of the diabetes.

Good luck, with keeping the weight down. I hope it all goes well for you.

I have tried to find out more about the treatment of diabetes pre1922( and the discovery of insulin) I am utterly coninced that many type 2 diabetics did well by careful low carb dieting and exercise.
Also I'm certain that Fat is Not the enemy. I used to eat low fat and ended up an overweight( well obese, by BMI) type 2 diabetic. Now I eat low carb and don't take much notice of my fat intake. I put butter on my veggies, eat whole milk yoghurt, put cream in my coffee, eat cheese and bacon and I've lost weight. I am having to replace my whole wardrobe. Even my undergarments and shoes don't fit any more. For a woman who loves clothes, it's heartbreaking to say goodbye to the things that looked good on even my junoesque figure and which I searched for with such effort. I've not finished yet, so I'm spending carefully in the interim. I don't intend to get thin After all I don't want to be scraggy in my 60s:>)
One extra effect that I've noticed is the improvement in my ultra-dry skin, now that II'm providing it with fatty acids. My heels don't crack any more. I used to leave bloody footprints all summer. And that awful itching of shins has become rare.
BMI is now merely in the "overweight" category. HbA1 about 6% each time. Lipds, bloodpressure and everything else well within targets.

Ally, it wasn't my intention to be patronising. I was trying to complement your dilligence and hard work.

Bit touchy, though!

All the best,

fergus

i though there was a hint of sarcasm - I know u think dietitians are useless!
Well maybe not all of us are!