Hounslow diabetes/cardiovascular meeting Tuesday June 26

This is the information I have for the next meeting. It should be interesting .... I will post the official notice when it comes.

The programme for the evening:
7.00pm Open for Tea and refreshments
7.25pm Darren Marsh: Diabetes specialist dietician
8.20pm Stavria Achilleos: Stroke and Cardiac Rehabilitation Dietitian
9.15pm Close

Venue:
Montague Public Hall, 30 Montague Road, Hounslow TW3 1LD
Montague Road is just off Hounslow High Street on the corner with Holy Trinity Church. The Hall is opposite Hounslow Police Station. There is ample free parking after 6.30pm in public car parks in Montague Road.

I look forward to seeing forum members there

Official notice of meeting & report of last meeting:

Once again a big thank you to everyone who attended the meeting last month. Your support helps the effort that the committee is making worthwhile.

We had two interesting presentations. The first was Alice Delemare from Diabetes UK who introduced the Charity’s “Putting Feet First Campaign”. It is important that we look after our feet by having regular checkups so that we can avoid complications where amputations may be necessary. It is necessary for us to lobby the PCT through LINK and other means not to cut funding for diabetes care. Please find enclosed copies of some of leaflets on caring for your feet.

Ian Day shared his experience and thoughts on a “Low Carbohydrate Diet”. This was a very interesting talk in which Ian stated that being on this diet he has managed to control and even reverse the complications of diabetes. He also challenged some assertions on diet made by Diabetes UK. If anyone is thinking of trying this diet, please consult your healthcare specialist. Notes of Ian’s talk will be available at our next meeting.

Our next meeting will be on Tuesday 26 June. The details of the meeting are given below

The programme for the evening:
7.00pm Open for Tea and refreshments
7.25pm Darren Marsh: Diabetes Specialist Dietician “Carbohydrate Awareness in Type 2 Diabetes”
8.15pm Stavria Achilleos: Stroke & Cardiac Rehabilitation Dietitian “Cardio Protective Diet “
9.05pm Raffle
9.15pm Close

enue:
Montague Public Hall, 30 Montague Road, Hounslow TW3 1LD
Montague Road is just off Hounslow High Street on the corner with Holy Trinity Church. The Hall is opposite Hounslow Police Station. There is ample free parking after 6.30pm in public car parks in Montague Road.

I look forward to seeing forum members there.

I will take notes

The first talk was: Stavria Achilleos: Stroke & Cardiac Rehabilitation Dietitian
“Cardio Protective Diet”

Her screen slides were very small & could not be read.

She mentioned factors we cannot control: Age, gender, heredity & the factors we can control: smoking, diabetes control, cholesterol, blood pressure, diet.

Mediterranean diet is recommended:
regular meals,
low fat/low salt/low sugar,
reduce total fat & particularly sat fat, avoid hydrogenated fats,
trim fat off meat & grill it,
eat whole grain carbs,
fruit & veg,
alcohol in moderation,
reduce salt (& don't use “low-salt” as it still gives us a taste for salt & contains potassium which may be undesirable)
oily fish – for omega 3
unsalted nuts,
chol reducing drinks rather than marg
rapeseed oil more stable than olive for cooking,
soya,
low fat dairy
read the labels,

Portion size & ratio of food components depends on whether we want to maintain our weight or reduce it. She showed 2 plate layouts.

She explained the components in lipids – cholesterol (HDL & LDL & trigs)

Have 30 mins exercise 5 days a week

She did not explain why fat reduction is so important, nor show a calculation of the amount of food to provide energy needs.

My comment was that that was the diet I had followed carefully since diagnoses & resulted in debilitating complications, particularly extreme tiredness & crippling muscle pains. Problems relieved by a reduced carb, higher fat diet.

Darren Marsh: Diabetes Specialist Dietician
“Carbohydrate Awareness in Type 2 Diabetes”

What is C? Where is C found? how does C affect diabetes? How much is required?

Preferred source of energy, includes fibre & vitamins

using the plate, we need 1/3 carbohydrate

each 85 g of carbohydrate raises blood gluc by 2 mmol (NB that needs clarifying)

50 g carb suggested for each meal (NB that is ½ what the DUK diet provides) depends on individual needs, including activity,

be careful with ready meals – read labels & don't eat extra - e.g pizza has 40 cals per slice, so an extra 1 or 2 slices is excessive.

He mentioned various diets to control blood glucose:
VLCD – v low calorie – short term, needs supervision
meal replacement liquid - short term, needs supervision
Low carbohydrate – up to 130 g per day
mediterranean diet
exercise plus diet
low fat

Low carbohydrate/high fat was nowhere suggested.

He was unaware of the Swedish LCHF citations & their conclusions, even though they are cited in the DUK Position Statement.

I asked if he though there would be any changes IN DUK's diet recommendations. NO!

I was glad to have Hana with me - thanks for coming. Please add your comments.

I am concerned that we were addressed by young professionals who did not seem to take into account patients' experience. "Your experience is you only - we are all different" is used to brush off most of what we say.

I hope, however, that these contacts can be followed up with further personal contact.

I have to agree that following what amounted to Stavria's diet might have protected my cardiovascular system - one can never know.

While my HbA1c since diagnosis (8.6) has generally been below 6-7, even when I was suffering, I was experiencing complication. I doubt if my HbA1c was enough to cause trouble, so was it carb itself, coupled with low fat? The fast up/fast down BG may have been to blame, even though measured levels were not high. There must be a thread somewhere.

noblehead said:

Are they mainly type 2's that attend these meetings Ian, what is the ratio of both types would you say?

Click to expand...

Probably mostly T2 but certainly some T1s. Some of the cardio folk left after the first talk.

I have asked the following of the speakers:
[GCLF = good carbs/low fat
LCHF = Low carb/high fat
MUFA = monounsat fat
PUFA = polyunsat fat
SFA = sat fat]

The diet favoured by dietitians (apart from DUK) seems to be controlled carbohydrate/low fat - 150 g carbs per day with minimal fat/oil. How can this provide adequate calories? 150 g carbohydrate provides about 600 cals. 150 g each chicken breast & lean beef provide 350 g cals. That leaves 600-1,000 cals to be derived from fruit & veg, & any fats that creep into our food. 1 Kg of carrots would provide 200 cals, & a further 40 g of carbohydrate. 5 apples would provide 400 cals, & a further 100 g of carbohydrate – double the 150 g carb you are suggesting. However 700 cals would be provided by naturally fatty foods.

1.Does the entire case for a low fat, particularly low sat fat diet, rest on a supposed link [of fat particularly SFA] with cholesterol & obesity, & are there studies that show such a link?
2.Are there any controlled studies that show the protective effects of the GCLF diet?
3.Bearing in mind relatively short term studies show the benefit, are there any controlled studies that show the long-term dangers of the LCHF diet?
4.As statins are widely prescribed, can we know that the GCLF diet is contributing to cholesterol control?
5.How is it possible to get adequate calories on a GCLF diet?
6.Is cholesterol control to less than 4 proven to be protective of cardio-vascular conditions?
7.Bearing in mind diabetics are warned that their condition is progressive, even if they follow the DUK dietary advice, a warning supported by experience, are there any controlled studies that show the long-term benefits of GCLF as against the LCHF diet?
8.Are there any studies that show the health advantages of MUFA & PUFA over SFA? SFA are more stable chemically, & don't need antioxidants.
9.Could my muscle pain problem have been caused by insufficient fat over a long period rather than elevated blood glucose? My HbA1c was 6.8 which my Dr did not consider unduly high.

Hopefully this could lead to a useful discussion with the speakers - can YOU help with the answers?

Still no answers from the experts - from members or the dietitians.
.