I Don't Understand The Nhs

I've got some experience in this; I wokr in Big Pharma and have conduced diabetes research for national charitied.

First Big Pharma will never fund a large-scale low carb study and why should they. They will literally lose money by people not using their drugs. Too much Big Pharma bashing goes on on this forum, most of us here would be dead without them; they need to make profits, or they wouldn't bother making drugs.

I worked on the National Diabetes Audit for DiabetesUK and that gave me access to some of the lead dietitians in DiabetesUK and let me tell you, they are stuck in the past; repeating the same dogma they were taught at uni (low fat high carb), without demonstrating any level of intelligence to think diabetics should eat fewer things that raise sugar levels. Simple thought, but they've got their fingers in their ears. If DiabetesUK thew their weight behind it, we wouldn't be having this conversation and i blame them for this, really.

I worked as chair of a research group at XPERT diabetes, which is run by Trudi Deakin, a very innovative and passionate dietitian and strong advocate of low carb diets. We conducted a pilot study that showed low carb diets are effective, but got turned down for funding for a large study. Many of you would have been on XPERT courses and they now offer low carb diet courses.

The tide is turning, although the pace of change is astonishingly glacial. I do thinks we'll get there. Carbs are being increasingly vilified and as may diabetics come to forums like this, or attend courses run by this website or XPERT, or read Bernstein's methods, the health advice will change.

If you want to support the LC diet to your HCP, this was updated in 2017,
https://www.sign.ac.uk/assets/sign116.pdf
'Short term (six months) low carbohydrate diets containing as little as 50 g carbohydrate per day (13% of daily energy)
120or 110 g per day (33% of daily energy)119
appear safe in type 2 diabetes whether treated by diet, tablets, insulin or a combination'

SIGN produce well respected guidelines for health professionals by the Scottish NHS
The worst thing that could happen is you should lose weight, which will make them happy.

This morning in my dietdoctor news email, they reported that the NHS is going to trial a liquid diet consisting of 4 serves of liquid nutrition and nothing else (800 cals per day) to diabetics for up to 5 months. They claim that it has a 46% success of maintaining weight loss after 1 year. I don't know how that is possible. I'm sure that many of us here have tried various shake based diets and can attest to their utter failure. Someone must be making a tremendous amount of money out of this, that's all I can say.

Guzzler said:

'experts' in the field who say that they are unconvinced that changes to the guidelines are needed

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Because they conveniently blame the patients for non-compliance. Not the failure of their recommendation.

But the key issue here is still the misdirection to focus on glucose rather than the chronic excessive insulin levels/response that basically plagues us all. Once it becomes clear that we should focus on a insulin sparing lifestyle, we will realize that there are many ways to achieve results...some more effortless and enjoyable than others.

Diets should be focused on not stopping people from eating but helping them make the right choices long term, and cutting out the ****.
My daughter went on a shake diet, lost five stones, and then promptly put it all back on because she was avoiding real food not making active choices to eat better food.
Its unfortunate but unlike smoking we can not just stop eating, so we will have to keep making 'good' choices for the rest of our lives, so the sooner we learn the better.
I have just had a 300 cal lunch of real food, which I enjoyed eating, and I feel full.

I have no idea what makes them think weight loss on a shake diet is sustainable unless they are providing post diet support. If they gave the support in the first place the shakes wouldn't be needed.

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ghost_whistler said:

My local NHS will not treat people if they eat 'extreme' or 'fad' diets, and keto is one they consider as such. If you have problems you will simply be told to eat properly.

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That's appalling...

We know our ancestors of tens thousands of years ago (before the heavy consumption of bread / wheat) lived on a diet of meat, nuts, berries, foraging, beans pulses etc, and I am sure they will have been super healthy people to survive those times, so how is it that these carb heavy diets are always pushed down our throats? 1 answer is definitely money...

Lord Midas said:

For decades the science for low carb benefits has been available. Though the ones with the money and power (big food, big pharma) have constantly tried to suppress this. Resulting in the advice that a carb heavy diet is healthy and will reduce the risk of heart attacks, etc
...
Big food and big pharma. That's why. It's a disgrace. We've allegedly got the best health service in the world yet the very advice they provide on nutrition is the very thing that will kill us (or at least make us all live lives that depend on medication).

:Angry Face:

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Here in the US we don't have any health service per se, yet we get the same "information" here as to carbs and heart "health." And talk about big pharma .... !

Today I have eaten almost no carbs at all, just meat, and I have been less hungry today than usual. Really haven't eaten much either, just mostly meat.

rosco 2 said:

The NHS is unable to promote strategies that are not evidence based.

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I am not a UK citizen, but curious....and your statement begs the question: what is the evidence base for their current position?

There are areas of the world that have huge carb based diets largely due to poverty and the lack of protein availability. Size is prized as being evidence of good health. HIV highlighted this for many of the people for whom I helped care. In the “developed” world, skinny in seen as desirable. It’s all about perspective, culture, tradition. However through all this cuts making money and fast food certainly knows how to appeal to our lazy, time poor natures. Evidence is published. Some years later someone else does another study or a meta analysis of existing studies and wow! established beliefs are turned on their heads. Science is only as good as the skills and understanding of those who do research. Integrity is a crucial factor in this too...

Bananas 2 said:

I am not a UK citizen, but curious....and your statement begs the question: what is the evidence base for their current position?

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It is simply another elaborate smoke and mirrors that big pharma employs...
"How evidence‐based medicine is failing due to biased trials and selective publication"
https://onlinelibrary.wiley.com/doi/full/10.1111/jep.12147

Evidence‐based medicine (EBM) was announced in the early 1990s as a ‘new paradigm’ for improving patient care. Yet there is currently little evidence that EBM has achieved its aim. Since its introduction, health care costs have increased while there remains a lack of high‐quality evidence suggesting EBM has resulted in substantial population‐level health gains.

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And it is often used as an excuse to disregard all the successes we see here as anecdotes..clinically useless because there is no RCT or long term safety studies. One would have thought that any sensible physicians would note the consistent successes and learn to leverage on it, but clearly their medical training in "evidence based medicine" has blinded most of them to any such possibility...

rosco 2 said:

There are areas of the world that have huge carb based diets largely due to poverty and the lack of protein availability. Size is prized as being evidence of good health. HIV highlighted this for many of the people for whom I helped care. In the “developed” world, skinny in seen as desirable. It’s all about perspective, culture, tradition. However through all this cuts making money and fast food certainly knows how to appeal to our lazy, time poor natures. Evidence is published. Some years later someone else does another study or a meta analysis of existing studies and wow! established beliefs are turned on their heads. Science is only as good as the skills and understanding of those who do research. Integrity is a crucial factor in this too...

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Yes.

I looked up some countries that have a "heavier" population than some others, and found, for one of them at least, that diabetes is one of the top three causes of death. That's all I've checked so far, haven't had time yet to do any comparisons, but I thought this was interesting, like your post.

MrsGruffy said:

This morning in my dietdoctor news email, they reported that the NHS is going to trial a liquid diet consisting of 4 serves of liquid nutrition and nothing else (800 cals per day) to diabetics for up to 5 months. They claim that it has a 46% success of maintaining weight loss after 1 year. I don't know how that is possible. I'm sure that many of us here have tried various shake based diets and can attest to their utter failure. Someone must be making a tremendous amount of money out of this, that's all I can say.

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This is essentially the Newcastle diet though, which aims to rapidly reduce visceral fat by restricting calories for the period it is operated. It has been very successful as an approach to type 2. It comes back to the point that there are a number of factors that drive people to make changes and a number of ways to make changes.