huge conflict with dietician

[Pneu]

This is a really interesting thread for me as a newly diagnosed T1.

I have a relatively low carb diet compared with a lot of people, but nowhere near 40g per day. I'd been moving my diet over the last few yeasr more towards low GI carbs from beans, pulses, lentils etc swapping potatoes for sweet potatoes as lower GI and having no more than one slice of dark rye bread a day. Even so with all that I'm around 150g per day for my main meals.

Then I come to sports. None of you mentions exercise here, so not sure what you do, but as a long distance runnner (training 5-6 times a week) I'm used to a slow drip feed of carbs for anything over a 90 minute run. After that you start to burn more fats but you still need to keep the blood sugars topped up to allow the fat burning mechanism to work from the physiology I've read.

I'm still geting used to the whole thing and having discussions with my dietician who specialises in helping athletes, but I'm a little concerned about her attitude to throwing more carbs at the problem. I'm hoping to educate her that you can run/exercise successully as an endurance athlete without huge volumes of carbs, and lower my (already low) insulin doses to match the physiology rather than the other way round

Dave not sure if you got a response to this one.. but a good place to go reference low carb is an American Doctor called Peter Attia.. one of his main areas of interest is endurance athletes and nutritional ketosis.. he is himself a marathon swimmer..

Here is a lecture / presentation he made at the Institute for Human and Machine Cognition (IHMC): http://www.youtube.com/watch?feature=pl ... qwvcrA7oe8

It's over an hour long but well worth a watch.

About how our body works when in nutritional ketosis (i.e. sub 50g carbs /day) and how actually as an endurance athlete this can improve performance as your body will burn ketones in preference to glucose... all pretty interesting.

 

[Dillinger]

I have to wonder what the skills that promote behaviour changes were?

Of course it still doesnt imply that a low carb diet is better than any other diet, just that it was found to be the better of the two diets in this particular study.

Neither does it address the fact that any very restrictive diet is almost impossible for the vast majority of people to follow long term.

Sid Bonkers I would say the following:

One such skill would be to review the carb content on the packaging of the food you are eating rather than the fat or calorie content. They don't list the skills but I don't think that is particularly sinister though.

The second point is true, but the type of diet it is being compared to is exactly the diet most newly diagnosed diabetics are put on here. A diet of only grilled yam, live locusts or only raw whale blubber may be better and you are perfectly right; they are not being tested. But it is important as it addresses the diet we are most interested in; the one our nurses/dieticians/GPs tell us to follow.

I don't think low-carb is very restrictive; less so than a low-calorie diet I would suggest. I accept that some people may have problems (and certainly looking around my nearest Tesco at lunch the low-carb products on offer must amount to about 5% of the stock) but if you know what to look for and use some imagination those problems can be overcome. Don't forget a number of people display almost addiction type behaviour with reference to bread and starchy carbs; that will go once you get over the initial hump.

I've been doing this type of diet for about 5 years; and haven't had any real problems sticking to it. In all that time my HbA1c has been better than 93.2% of all Type 1 diabetics (i.e. it has never been over 6.5% in old money) although it's not better than Pneu's it should be pointed out. I consider that sustainable and successful.

Dillinger

 

[Unbeliever]

[quote="xyzzy.

Relating it back to dieticians and specifically T2 then given that you agree that LC does work for newly diagnosed people then don't you think it should at least be presented to people as a formalised treatment method? That's my fundamental objection to those that are anti LC; they are denying a valid treatment method that has been adopted and is successfully practised in other countries. I think its good that the ADA seem to finally be waking up to fact that it works. It seems to be continuing the ADA trend of gradual acceptance of LC as a means of control over the past few years.

For T1's the LC argument is subtly different and equally compelling but as I'm not T1 I wont comment further.

Take care

Steve[/quote]

Exactly. How can anyone disagree? I have never been able to understand why anyone would want to deny people access to information which might help them As things stand many find that reducing starchy carb inake works when everything else has failed.
That was certainly my experience. I have been lowcarbin for over 3 years and my HBA1C continues to improve .I too can now olerate more carbs . I am a "slim T2 and I hink i can often be more difficult to find a way of conrolling bgs. I was advised to eatMORE carbs on diagnosis with the inevitable outcome!

The fact that some might find it restrictive and unsustainable should not be a reson for people not to atttempt it.
How willwe ever learn abou the long term effects if everyone is to be discouraged from following it long term?

I followed the GI system for many years before dignosis . It did not prevent diabetes developing bu may well have delayed it.
is that a reason to dismiss a GI diet?

 

[wiflib]

As I have often stated here and elsewhere, I would, in a heartbeat go back to a diet inclusive of buttered toast, a portion of new potatoes, crunchy cereal with ice cold milk and pasta bolognese, but I can't. Not even a quarter of a slice or a small handful of the other stuff. I know this because I was able to test, test test in the early days.
My body simply can't handle the diet that Sid and others have described and/or follow and as I don't want to die the slow, horrible death my father did, I HAVE NO CHOICE but to continue with a diet that is sub 30g of carbs a day.

I'm into my sixth year of my new life and do I find it hard and restrictive? Do I sob quietly every time I see others enjoy the chocolate we are given at work, or when I smell the hot toast I make for the new mothers? Maybe for a fleeting second but I remember what I was over five years ago and I'm not going back to that so for those of you that don't have to eat the way I do, stop telling me my diet is unsustainable, lacking, irresponsible or may kill me. Be thankful that you DON"T have to eat my diet.

I'll take my chances thanks, and my HbA1c of 4.6

wiflib, who has not long eaten her dinner of chicken, mushrooms and french beans in a creamy garlic and cheese sauce with lots of black pepper on. Yum.

 

[paul-1976]

Wow! Great post Lib! I'm sticking to it too-HbA1c down from 14.1% to my most recent of 5.1%,I doubt I'll ever join the 4% club but I'm feeling so much better these days,sustainable? well it has been for me BUT it's had to be BUT I'm enjoying food again that I was told were "The devils urine" so to speak,I'm not hungry and my bloods are much improved and my BMI is around 21-22 so I'll take my chances too.

 

[wiflib]

Thanks Paul, much appreciated. It's not like it's hard to do, is it.

We will be on the telly at the age of 110, after running a half marathon and they will ask us what our secret is. I wonder what the answer will be? ;-)

 

[mpe]

There's no evidence anywhere that we need ANY dietary carbs. the RDAs are based on guesswork.

The factors involved appear to include "Calories count."; "Fats (especially saturated) are bad." & "Sugars are bad (but not as bad as fats)."
Which results in a diet which is not only very high carbohydrate but also biased towards glucose polysaccharides.

 

[mpe]

I hope my tolerance will further improve but until it does I would still rather carb restrict to keep healthy than take a load of hypo inducing and weight promoting drugs just so I can eat more rice, pasta, bread, cereals and potatoes.

Not everyone is going to like these foods in the first place. Even those who do might not regard them as "essential".

 

[mpe]

Exactly. How can anyone disagree? I have never been able to understand why anyone would want to deny people access to information which might help them As things stand many find that reducing starchy carb inake works when everything else has failed.
That was certainly my experience. I have been lowcarbin for over 3 years and my HBA1C continues to improve .I too can now olerate more carbs . I am a "slim T2 and I hink i can often be more difficult to find a way of conrolling bgs. I was advised to eatMORE carbs on diagnosis with the inevitable outcome!

The fact that some might find it restrictive and unsustainable should not be a reson for people not to atttempt it.
How willwe ever learn abou the long term effects if everyone is to be discouraged from following it long term?

Many people would find the "Eatwell Plate" diet "restrictive" and/or "unsustainable" (even amongst non diabetics.) Yet this is pushed as a "one size fits all".

Also a high glucose diet for a diabetic makes about as much sense as a high gluten diet for a coeliac...

 

[James12]

welome to the world of T1D - everyone has their own opinion. Im sorry you came across this kind of health carer, the advice she is giving you sounds potentially life threatening, eating industrial amounts of carbs requires 'industrial' amounts of insulin and makes your blood sugars hard to predict - not to mention the amount of weight you will gain. I advise you to find another dietician who dose not suffer from insanity and make sure your health care team is supportive. Your endocrinologist is likely to give the best advice, since he or she will actually be qualified to give the right info.


I managed to normalise my blood sugars using Dr. Bernsteins diabetes solution and Think like a pancreas (books)

Last A1C 4.5
Type 1 for 2 years.

 

[mpe]

welome to the world of T1D - everyone has their own opinion. Im sorry you came across this kind of health carer, the advice she is giving you sounds potentially life threatening, eating industrial amounts of carbs requires 'industrial' amounts of insulin and makes your blood sugars hard to predict - not to mention the amount of weight you will gain.

In which case you would be eating "too much" in the first place. Excess glucose is converted to fat in either the liver or fat cells. In either case insulin is required.
Whereas excess fructose and galactose appear to be converted to fat entirely by the liver, often as soon as it enters the liver through the hepatic portal vein. The liver being entirely responsible for regulation of these two sugars in the blood.

Fat produced in the liver enters the blood in VLDL (along with some cholesterol). Thus if the liver is converting a lot of sugar to fat both total cholesterol and "tri-glycerides" will increase. The level of VLDL does not itself appear to do much to the levels of LDL or HDL (hardly anyone appears to bother testing for IDL). But would affect ratios.

The human body needs to the concentration of water soluble compounds in the blood to be tighly regulated. Lipoprotein particles are similar to living cells. With the number in the blood being able to vary over a wide range without any effect on plasma chemistry.

 

[Ricky]

I'm afraid health professionals can't think further than the latest guidelines and that is it. But we know that we know better and we have clinical proof of this!!! I have managed to stay off meds for 7 years now with low carbing but I have to admit it is becoming more difficult to stay below fasting readings of <6.0. I am still persisting though.

 

[mikegresty]

carbs are vital to function like fuel in a car the more we burn the more we need failure to adhere to this rule will result in ketosis or the more lethal version of ketoacidosis which is particularly bad and often deadly and is caused by your body using fat supplies to replace carbs when they aren't available and these fat cells basically poison the blood. I've suffered from this twice in 30 years and both times only just escaped with my life after multiple weeks in hospital recovering.

 

[fatbird]

"carbs are vital to function"

"There are three kinds of foods--fats, proteins, and carbohydrates. All of these provide calories. But the carbohydrates provide calories and nothing else. They have none of the essential elements to build up or to repair the tissues of the body. A man, given carbohydrates alone, however liberally, would starve to death on calories. The body must have proteins and animal fats. It has no need for carbohydrates, and, given the two essential foodstuffs, it can get all the calories it needs from them."

Sir Heneage Ogilvie, former vice president of the Royal College of Surgeons, England.
FB

 

[mpe]

First clinic appt and I'm on very low carbs.

Reduced insulin use by 2/3 since going this way.

Glucose between 5-6.

She was insistent that I needed/ to eat loads more carbs/pizza/chocolate/ice Cream!!!!!!! Just take more insulin!!

When I questioned back she had no explanation at all to back her advice up!

I asked what kind of illness/deficiency would I get from low carbs(40g less)Again no answer!

If she has nothing to back this up how can you be sure if you are getting anything other than dogma?

I have since emailed over studies backing up my approach although not expecting a positive response.

They are apparently very concerned over this!!!!

Madenning!!!!!

If they are concerned, but you arn't then it's their problem rather than yours.

 

[mikegresty]

may I just add that after one very bad hypo I almost bit my tongue off and did lose most my memory I spent 3 weeks in hospital not knowing who I was or what had happened. hypos are not to be messed with or taken lightly and avoidance requires good control and carbs plus more carbs when the situation requires it through either cold weather, excercise in excess of normal, drinking alcohol and even stress.

 

[mpe]

still should she really be telling me i can eat whatever i want and then list some of the worst **** out there?

There was no mention of any healthy alternatives at all!

In practice some of the "healthy alternatives" are likely to be worst than some of the "****". When you start looking at GI and GL. Added to which there is a huge variation in. what's actually in "ice cream", "chocolate" or "pizza".

 

[Daibell]

carbs are vital to function like fuel in a car the more we burn the more we need failure to adhere to this rule will result in ketosis or the more lethal version of ketoacidosis which is particularly bad and often deadly and is caused by your body using fat supplies to replace carbs when they aren't available and these fat cells basically poison the blood. I've suffered from this twice in 30 years and both times only just escaped with my life after multiple weeks in hospital recovering.

Probably worth saying that Ketoacidosis only happens when you are in Ketosis AND have VERY high blood sugar. Ketosis with normal blood sugar is not a problem. Also the body doesn't need the general carbs group. The brain does need glucose but most other foods can provide that as and when needed via the liver

 

[mikegresty]

a

Probably worth saying that Ketoacidosis only happens when you are in Ketosis AND have VERY high blood sugar. Ketosis with normal blood sugar is not a problem. Also the body doesn't need the general carbs group. The brain does need glucose but most other foods can provide that as and when needed via the liver[/quote anyone can suffer ketosis diabetic or not it's the acidosis part that differentiates the two but high blood sugar is not necessary to get it in fact simply not eating carbs for 2 days can cause this in a diabetic such was the case for me I was in pain and couldn't eat properly and so avoided eating much at adjusting my insulin to suit but then the ketoacidosis started by which time I couldn't hold down any food or liquid and was constantly throwing up at each attempt to drink eat or even breathe i got a short lucky break and got hold of a doctor but the second time I learnt it was much safer to call an ambulance and leave my door open for them as the ability to function with Dka is almost zero

 

[fatbird]

Ketosis / Ketoacidosis

Diabetics, and even some health professionals, often confuse two quite distinct metabolic processes - ketosis and ketoacidosis. Ketosis is a perfectly natural and healthy state during which the body uses stored or dietary fat for fuel. In order to enter this state, carbohydrate intake needs to fall below a certain level. Ideally, a healthy metabolism should regularly use ketosis, while fasting overnight for example, to fuel the body's processes and utilise stored fat reserves. Most of the body's organs, the heart for example, in fact run very efficiently on ketones.

Ketoacidosis is quite different and is typically the result of a chronic lack of insulin, not a lack of carbohydrate. With insufficient insulin, the body attempts to fuel itself by breaking down fat and protein stores in an uncontrolled way, a process which results in the blood becoming dangerously acidic. In short, ketosis usually occurs when blood sugars are at the lower end of the normal range, and ketoacidosis occurs when blood sugars are dangerously elevated. Ketosis is a result of low carbohydrate intake, ketoacidosis is a result of inadequate insulin levels.

The benefits of reduced insulin levels also apply to type 1’s. Insulin has a measureable impact on blood vessels by narrowing them, with increased cardiovascular risks. Smaller doses can also make blood glucose fluctuations far more predictable, resulting in fewer highs and lows. It is not true to say that type 1’s need carbohydrates to feed their insulin. They may simply need less insulin.

http://www.diabetes.co.uk/forum/threads/low-carb-diet-a-newbies-guide.9427/

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